A retired NHS physiotherapist from north London has described how a new ovarian cancer treatment has allowed her to “get on with life” in a way she never could during three previous rounds of chemotherapy. Patricia Hill, 64, began taking mirvetuximab soravtansine — marketed as Elahere — in January this year after her cancer stopped responding to standard chemotherapy within six months, a condition known as platinum-resistant disease. “Previously, I’ve had three different lines of chemotherapy, and this is the first time that I’ve actually been able to get on with my life in terms of the impact of side effects,” she said.
For patients like Hill, whose advanced ovarian cancer has become resistant to conventional treatment, the options have been limited for more than two decades. Elahere is the first new ovarian cancer drug approved for NHS use in England in that time — a “significant breakthrough”, according to NHS England, which estimates up to 400 women a year could now benefit.
How Elahere targets cancer cells
Unlike chemotherapy, which attacks all rapidly dividing cells and causes a wide range of debilitating side effects, Elahere is a targeted therapy. It works by attaching to a specific protein called folate receptor-alpha (FRα) that is found on the surface of some ovarian cancer cells. Once attached, it delivers a cancer-killing agent directly to the tumour — a mechanism that has been described as a “biological missile”. The treatment is approved for women with platinum-resistant epithelial ovarian, fallopian tube or primary peritoneal cancer whose tumours contain the FRα protein and who have received between one and three previous lines of chemotherapy.
Clinical evidence backs up the promise. In the MIRASOL study involving 453 adults, women who received Elahere lived an average of 16.9 months compared to 13 months for those given chemotherapy. The drug also delayed cancer progression: an average of 5.6 months passed before the disease worsened on Elahere, versus 4 months on chemotherapy. A separate global clinical trial found that Elahere delayed progression and prolonged survival by an average of four months, with more manageable side effects. In that trial, tumours shrank by at least 30% in 37% of patients taking Elahere, compared to just 16% of those on chemotherapy.
A more manageable experience
The difference in day-to-day life is substantial. Chemotherapy often requires frequent hospital visits and causes severe fatigue, hair loss, nausea and long-term nerve damage — side effects that Hill said had put her life on hold, leading to isolation and reliance on others. Elahere, by contrast, is given once every three weeks and has a more manageable side-effect profile. For Hill, this has meant she can resume normal activities without the constant disruption of treatment-related illness.
The National Institute for Health and Care Excellence (NICE) has recommended Elahere for NHS use, and it is now available under a confidential commercial agreement between the manufacturer AbbVie and NHS England. The approval comes against a stark backdrop: ovarian cancer is the sixth most common cancer in women in the UK, with around 7,500 new cases diagnosed annually. More than three-quarters of patients are diagnosed at an advanced stage, partly because early symptoms are vague — the disease is often called the “silent killer”. Survival figures highlight the urgency: around 40% of women survive for 10 years or more, and the five-year survival rate in the UK is roughly 45%, below the European average. Early detection dramatically improves outcomes — 95% of Stage I patients live at least five years, compared to about 17% of those diagnosed at Stage IV.
Historically, standard care has involved surgery and chemotherapy, but about 80% of patients with advanced disease relapse and eventually become resistant to chemotherapy. Before Elahere, the most significant targeted advances came from PARP inhibitors, which prevent cancer cells from repairing themselves. Drugs such as olaparib (Lynparza), niraparib (Zejula) and rucaparib (Rubraca) are used as maintenance therapy to delay recurrence in certain patient groups. Many of these were initially made available through the Cancer Drugs Fund, a scheme that provides early access to promising treatments while further evidence is collected. Bevacizumab (Avastin) is also used in combination with chemotherapy and as a maintenance option.
Research continues into new approaches, including immunotherapy — a trial of pembrolizumab alongside standard care extended survival for some platinum-resistant patients. Scientists are also developing blood tests to predict treatment response and detect tumours earlier, as well as personalised risk prediction tools such as CanRisk, which factors in genetic, lifestyle and hormonal information. New drug combinations, such as olaparib with cediranib for relapsed disease, are being investigated. These efforts, together with the arrival of Elahere, represent a steady shift toward more precise, less punishing treatments for a disease that has long been difficult to manage.
