Emerging Treatments
Trials are looking at using MIRV earlier in treatment, including before the cancer becomes platinum-resistant, says Lewin. Others are investigating new drug combinations and targeted therapies that may make more treatment options available, she adds. Some of these treatments are in the earlier phases of clinical trials that focus on safety and finding the right dose (phase 1 or 2). Others are in a later phase, phase 3, which compares new treatments with existing ones in larger groups of participants. The treatments being studied have not been approved by the FDA.
Sofetabart Mipitecan
Sofetabart mipitecan (LY4170156) is an ADC being studied for FR-alpha–positive ovarian cancer. Like MIRV, it targets the FR-alpha protein, but it uses a different chemotherapy drug.
So far, this medication appears to work in people with platinum-resistant ovarian cancer with all levels of FR-alpha expression. This may make it an option for people with lower FR-alpha expression who may not qualify for MIRV.
In January 2026, sofetabart mipitecan received the FDA’s Breakthrough Therapy designation for certain people with platinum-resistant ovarian cancer, which can help speed up the development and review process. A large phase 3 trial is underway to compare it with current treatments.
MIRV Plus Bevacizumab
MIRV is approved for certain platinum-resistant cancers. But researchers are studying whether it could also help people with platinum-sensitive recurrent disease, says Lewin, meaning the cancer returned more than six months after platinum-based treatment.
One approach is a combination of MIRV and bevacizumab (Avastin), a drug that helps block the blood supply that tumors need to grow, says Cohen.
A phase 3 study is evaluating this combination in people with high FR-alpha expression and recurrent platinum-sensitive ovarian cancer.
The goal is to see whether continuing treatment with this combination after the initial therapy, known as maintenance therapy, can keep the cancer under control longer and delay it from coming back.
MIRV Plus Carboplatin
Another combination approach is MIRV and carboplatin. A phase 2 study is looking at this combination, followed by MIRV alone, for people with platinum-sensitive ovarian cancer. This combination could be another way to improve outcomes, and larger studies are needed for final results.
A separate phase 2 trial is studying this same combination in people who are newly diagnosed with advanced FR-alpha–positive ovarian cancer and are candidates for chemotherapy before surgery. This trial is looking at whether giving this combination treatment before and after surgery could improve outcomes for these patients.
Farletuzumab Ecteribulin
Farletuzumab ecteribulin (MORAb-202) is an ADC in clinical trials for platinum-resistant ovarian cancer. It uses an FR-alpha–targeting antibody but with a different chemotherapy drug than MIRV, says McCormick.
Phase 1 findings showed that depending on the dose, this treatment may help shrink tumors in some people with various levels of FR-alpha expression. With this therapy, lung inflammation has been a side effect that researchers are watching closely. Studies are ongoing to evaluate appropriate doses and treatment effectiveness.
ZW191
ZW191 is an FR-alpha–targeting ADC currently being studied in people with all levels of FR-alpha expression.
This treatment is designed to kill not just the targeted cancer cells but also nearby cells that may have little to no FR-alpha on their surface. This could help target more of the tumor, since not all cancer cells express the same amount of FR-alpha.
In March 2026, the FDA granted this treatment its Fast Track designation for platinum-resistant ovarian cancer. This program is meant to speed up the development and review of treatments that show promise for serious conditions, though it does not mean the drug is approved. ZW191 is in a phase 1 trial to evaluate safety and how well it works.
FR-Alpha Targeted Vaccines
Researchers are exploring vaccines that train the immune system to recognize and attack cancer cells carrying FR-alpha. These are called dendritic cell vaccines; they are made from a patient’s own white blood cells that are then processed in a lab.
When these cells are reintroduced into the body as vaccines, they help guide the immune system to target and attack cancer cells carrying FR-alpha.
Some clinical trials are testing this vaccine in people with ovarian cancer, including after initial treatment and when cancer has come back. Other studies are combining the vaccine with immunotherapy drugs like pembrolizumab (Keytruda) to help strengthen the immune response. These are in phase 1 and 2 trials.
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