Advancing Treatment Strategies in Ovarian Cancer: The Evolving Role of Antibody-Drug Conjugates

Panelists discuss how treatment approaches differ between platinum-sensitive and platinum-resistant ovarian cancer patients, emphasizing the use of platinum doublets and maintenance therapies in sensitive cases versus the limited options historically available for resistant cases.

Panelists discuss how molecular testing strategies prioritize BRCA and HRD status at diagnosis while incorporating folate receptor alpha and other biomarkers in the recurrent setting to guide treatment decisions and clinical trial eligibility.

Panelists discuss how overcoming barriers to molecular testing in ovarian cancer requires addressing logistical challenges like tissue availability and external pathology coordination, managing financial constraints through institutional support and low-cost options, and enhancing patient communication by clearly explaining how testing creates a personalized treatment roadmap that empowers patients to pursue tailored therapies based on their tumor's genetic and molecular profile.

Panelists discuss how the Mirasol trial's demonstration of superior response rates (42% vs 15.9%) and overall survival (16.5 months) for the FDA-approved folate receptor alpha-positive ADC represents a revolutionary advancement in platinum-resistant ovarian cancer treatment, offering patients prolonged responses with better tolerability and quality of life compared to standard chemotherapies.

Panelists discuss how the rapidly expanding ovarian cancer ADC pipeline offers promising therapeutic options with diverse payloads targeting folate receptor alpha and HER2, providing sequencing opportunities and personalized treatment approaches despite varying toxicity profiles.

**Sequencing and Patient Readiness for ADC Therapy:** Panelists discuss how ADC therapy approval has reshaped ovarian cancer treatment sequencing by prioritizing these agents over traditional regimens in platinum-resistant patients with high folate receptor alpha expression, while emphasizing the critical need for patient education about unpredictable novel side effects and continuous monitoring based on patient-reported symptoms.

Managing Ocular Side Effects of ADCs ADC therapy often leads to ocular side effects, requiring proactive management. A typical patient scenario involved mild vision issues that escalated to moderate keratopathy. Regular ophthalmologic monitoring and timely intervention allowed continuation of treatment at a reduced dose while maintaining visual function. Standard care includes a baseline eye exam, ongoing optometry visits, steroid and lubricating drops, and close coordination between oncology and eye care. Dose holds and reductions based on severity are effective in reversing toxicity while maintaining disease control. This case illustrates that with proper planning, patients can stay on effective therapy despite complications. Collaborative care between oncologists and eye specialists ensures that ocular side effects are addressed early, allowing treatment continuity and preserving quality of life.

Panelists discuss how successful ADC administration requires robust coordination between oncology and eye care teams through same-day appointments and shared medical records at academic centers, while emphasizing the need for partnerships with local eye care providers, standardized protocols, and expanded provider education to ensure safe delivery in community settings as more ADCs enter clinical use.

Panelists discuss how managing ADC-related ocular toxicity requires vigilance through slit-lamp exams and visual acuity testing, with early intervention including treatment holds or dose reductions being essential to prevent long-term damage, while emphasizing the need for collaborative decision-making between oncologists and ophthalmologists to balance cancer control with reversible side effects and maintain patient quality of life.

Counseling Patients on ADC Side Effects Patient education is a cornerstone of successful ADC treatment. When introducing ADCs, providers focus on transparency—discussing the most common side effects upfront and reinforcing that many are reversible with dose holds or modifications. Eye toxicities and lung-related side effects like pneumonitis often cause anxiety. Clear communication and reassurance that these can be managed effectively help build trust. Educational materials and follow-up calls ensure patients feel supported and informed. Ultimately, the goal is to empower patients to report symptoms early and remain engaged in their care. ADC therapy offers significant clinical benefit, and with proactive management, patients can achieve extended survival and maintain their quality of life throughout treatment.