Mirvetuximab soravtansine: Drug information

(For additional information see "Mirvetuximab soravtansine: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)

ALERT: US Boxed Warning

Ocular toxicity:

Mirvetuximab soravtansine can cause severe ocular toxicities, including visual impairment, keratopathy, dry eye, photophobia, eye pain, and uveitis. Conduct an ophthalmic exam, including visual acuity and slit lamp exam, prior to initiation of mirvetuximab soravtansine, every other cycle for the first 8 cycles, and as clinically indicated. Administer prophylactic artificial tears and ophthalmic topical steroids. Withhold mirvetuximab soravtansine for ocular toxicities until improvement and resume at the same or reduced dose. Discontinue mirvetuximab soravtansine for grade 4 ocular toxicities.

Brand Names: US

Elahere

Pharmacologic Category

Antineoplastic Agent, Anti-Folate Receptor Alpha;
Antineoplastic Agent, Antibody Drug Conjugate;
Antineoplastic Agent, Antimicrotubular;
Antineoplastic Agent, Monoclonal Antibody

Dosing: Adult

Dosage guidance:

Safety: Premedication, as well as lubricating and ophthalmic topical steroid eye drops, during mirvetuximab soravtansine treatment are recommended.

Clinical considerations: Mirvetuximab soravtansine is associated with a moderate emetic potential; antiemetics are recommended to prevent nausea and vomiting.

Ovarian cancer, platinum-resistant, folate receptor-alpha positive

Ovarian cancer, platinum-resistant, folate receptor-alpha positive (epithelial ovarian, fallopian tube, or primary peritoneal cancer): IV: 6 mg/kg (based on adjusted ideal body weight) once every 3 weeks; continue until disease progression or unacceptable toxicity (Ref).

Note: Adjusted ideal body weight (AIBW) calculated with the following formula:

AIBW = Ideal body weight (kg) + 0.4 × (actual weight [kg] − ideal body weight [kg])

Female ideal body weight (kg) = 0.9 × height (cm) − 92

Premedication:

**Mirvetuximab Soravtansine Premedication^a**
Premedication and route	Example (or equivalent)	Premedication administration time
^a For patients who experience infusion-related reactions, consider additional premedications (including corticosteroids) on the day prior to mirvetuximab soravtansine administration.
^b Allow at least 10 minutes to elapse after instilling ophthalmic topical steroids and before administering lubricating eye drops.
Corticosteroid (IV)	Dexamethasone 10 mg	At least 30 minutes prior to each mirvetuximab soravtansine dose.
Antihistamine (oral or IV)	Diphenhydramine 25 mg to 50 mg
Antipyretic (oral or IV)	Acetaminophen 325 mg to 650 mg
Antiemetic (oral or IV)	5HT₃ serotonin receptor antagonist (or appropriate alternative)	Prior to each mirvetuximab soravtansine dose and thereafter, as needed.
Ocular premedications	Ophthalmic topical steroids^b	Begin ophthalmic topical steroids only after ophthalmic examination with a slit lamp. Administer 1 drop of ophthalmic topical steroids into each eye 6 times daily starting the day prior to each mirvetuximab soravtansine infusion and continue until day 4, then administer 1 drop into each eye 4 times daily for days 5 to 8 of each mirvetuximab soravtansine cycle.
Ocular premedications	Lubricating eye drops^b	Administer lubricating eye drops at least 4 times daily and as needed during mirvetuximab soravtansine treatment.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

CrCl ≥30 mL/minute: No dosage adjustment necessary.

CrCl <30 mL/minute: There are no dosage adjustments provided in the manufacturer's labeling (effects are unknown).

End-stage kidney disease: There are no dosage adjustments provided in the manufacturer's labeling (effects are unknown).

Dosing: Hepatic Impairment: Adult

Mild impairment (total bilirubin ≤ ULN and AST > ULN or total bilirubin >1 to 1.5 times ULN and any AST): No dosage adjustment necessary.

Moderate to severe impairment (total bilirubin >1.5 times ULN): Avoid mirvetuximab soravtansine use.

Dosing: Obesity: Adult

Note: The manufacturer recommends calculating the dose based on adjusted ideal body weight.

American Society of Clinical Oncology guidelines for appropriate systemic therapy dosing in adults with cancer with a BMI ≥30 kg/m²: Manage regimen-related toxicities in the same manner as for patients with a BMI <30 kg/m²; if a dose reduction is utilized due to toxicity, may consider resumption of previously tolerated dose level with subsequent cycles only if dose escalations are allowed in the prescribing information, if contributing underlying factors (eg, hepatic or kidney impairment) are sufficiently resolved, AND if performance status has markedly improved or is considered adequate (Ref).

Dosing: Adjustment for Toxicity: Adult

**Mirvetuximab Soravtansine Dosage Reduction Levels**
^a AIBW = adjusted ideal body weight.
^b Permanently discontinue if unable to tolerate 4 mg/kg AIBW.
Starting (usual) dose	6 mg/kg (based on AIBW^a)
First dose reduction	5 mg/kg (based on AIBW)
Second dose reduction	4 mg/kg (based on AIBW)^b

**Mirvetuximab Soravtansine Dosage Modifications for Adverse Reactions**
Adverse reaction	Severity	Mirvetuximab soravtansine dosage modification
Infusion-related reactions/hypersensitivity	Grade 1	Maintain infusion rate.
	Grade 2	Interrupt infusion and administer supportive treatment. After recovery from symptoms, resume the infusion at 50% of the previous rate. If no further symptoms occur, increase infusion rate as appropriate until infusion is completed. Administer additional premedication in future cycles.
	Grade 3 or 4	Immediately stop infusion and administer supportive treatment. Advise patient to seek emergency treatment immediately and notify health care provider if infusion symptoms recur. Permanently discontinue mirvetuximab soravtansine.
Ocular toxicity (any)	Any	Lubricating and ophthalmic topical steroid eye drops during mirvetuximab soravtansine treatment are recommended.
Ocular toxicity: Keratitis/Keratopathy	Nonconfluent superficial keratitis	Monitor.
	Confluent superficial keratitis, a cornea epithelial defect, or ≥3-line loss in best corrected visual acuity	Withhold mirvetuximab soravtansine until improved or resolved, then maintain at same dose level or consider dose reduction.
	Corneal ulcer or stromal opacity or best corrected distance visual acuity 20/200 or worse	Withhold mirvetuximab soravtansine until improved or resolved, then reduce by 1 dose level.
	Corneal perforation	Permanently discontinue mirvetuximab soravtansine.
Ocular toxicity: Uveitis	Grade 1 (rare cell in anterior chamber)	Monitor.
	Grade 2 (1 to 2+ cell or flare in anterior chamber)	Withhold mirvetuximab soravtansine until ≤ grade 1, then maintain dose at same dose level.
	Grade 3 (3+ cell or flare in anterior chamber)	Withhold mirvetuximab soravtansine until ≤ grade 1, then reduce by 1 dose level.
	Grade 4 (hypopyon)	Permanently discontinue mirvetuximab soravtansine.
Peripheral neuropathy	Grade 2	Withhold mirvetuximab soravtansine until ≤ grade 1, then reduce by 1 dose level.
Peripheral neuropathy	Grade 3 or 4	Permanently discontinue mirvetuximab soravtansine.
Pulmonary toxicity: Pneumonitis	Grade 1	Monitor. Patients who are asymptomatic may continue mirvetuximab soravtansine with close monitoring.
	Grade 2	Withhold mirvetuximab soravtansine until ≤ grade 1, then resume at same dose level or 1 lower dose level at the discretion of the health care provider.
	Persistent or recurrent grade 2	Withhold mirvetuximab soravtansine until symptoms resolve to ≤ grade 1 and consider dose reduction.
	Grade 3 or 4	Permanently discontinue mirvetuximab soravtansine.
Other adverse reactions	Grade 3	Withhold mirvetuximab soravtansine until ≤ grade 1, then resume at 1 lower dose level.
Other adverse reactions	Grade 4	Permanently discontinue mirvetuximab soravtansine.

Dosing: Older Adult

Refer to adult dosing.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Reported adverse reactions are for adults.

>10%:

Endocrine & metabolic: Decreased serum albumin (31%), decreased serum magnesium (27%), decreased serum potassium (15%)

Gastrointestinal: Abdominal distention (11%), abdominal pain (36%), constipation (30%), decreased appetite (18%), diarrhea (31%; grades 3/4: 3%), nausea (40%), vomiting (19%)

Hematologic & oncologic: Decreased hemoglobin (25%; grades 3/4: 3%), decreased neutrophils (26%; grades 3/4: 3%), leukopenia (26%; grades 3/4: 1%), lymphocytopenia (35%; grades 3/4: 7%)

Hepatic: Increased serum alanine aminotransferase (39%), increased serum alkaline phosphatase (30%), increased serum aspartate aminotransferase (50%)

Nervous system: Fatigue (49%; including asthenia), neuropathy (33% to 36%; grades 3/4: 2%; including hypoesthesia [2%], neuralgia [<1%], neurotoxicity [3%], oral hypoesthesia [<1%], paresthesia [6%], peripheral motor neuropathy [1%], peripheral neuropathy [19%], peripheral sensory neuropathy [9%], and polyneuropathy [<1%])

Neuromuscular & skeletal: Arthralgia (17%)

Ophthalmic: Cataract (15% to 18%), corneal disease (36% to 37%; including corneal deposits, epithelial keratopathy [microcysts and defect], keratitis, and punctate keratitis]), dry eye syndrome (26% to 27%), eye pain (10% to 12%), photophobia (13% to 17%), visual impairment (49% to 50%; including accommodation disturbance, blurred vision, decreased visual acuity, diplopia, error of refraction, presbyopia, and vitreous opacity)

Renal: Increased serum creatinine (16%)

Respiratory: Dyspnea (12%)

1% to 10%:

Gastrointestinal: Intestinal obstruction (serious: 8%)

Hematologic & oncologic: Thrombocytopenia (5%)

Hepatic: Ascites (serious: 4%)

Hypersensitivity: Hypersensitivity reaction (≤9%), infusion-related reaction (≤9%)

Infection: Serious infection (3%)

Neuromuscular & skeletal: Myalgia (10%)

Ophthalmic: Uveitis (1%)

Respiratory: Pleural effusion (serious: 3%), pneumonitis (8% to 10%)

Frequency not defined: Hepatic: Increased gamma-glutamyl transferase

Contraindications

There are no contraindications listed in the manufacturer's labeling.

Warnings/Precautions

Concerns related to adverse effects:

• Ocular adverse reactions: Mirvetuximab soravtansine can cause severe ocular adverse reactions. Ocular adverse reactions occurred in over half of patients. Grade 3 ocular adverse reactions occurred, including visual impairment, keratopathy/keratitis (corneal disorders), dry eye, photophobia, and eye pain; one case of grade 4 keratopathy was reported. The most common ocular adverse reactions were visual impairment, keratopathy, dry eye, cataract, photophobia, and eye pain. The median time to onset of first ocular adverse reaction was 1.2 months (range: up to ~13 months). Of patients experiencing ocular events, almost half had complete resolution, while over one-third had partial improvement (decrease in severity by one or more grades from the worst grade) at last follow-up. Ocular adverse reactions led to permanent discontinuation in a small percentage of patients. Premedication as well as lubricating and ophthalmic topical steroid eye drops during mirvetuximab soravtansine treatment are recommended. Advise patients to avoid use of contact lenses during mirvetuximab soravtansine treatment unless directed by a health care provider.

• Peripheral neuropathy: Peripheral neuropathy occurred in over one-third of patients; grade 3 peripheral neuropathy was reported (rare). Neuropathy included peripheral neuropathy, peripheral sensory neuropathy, paraesthesia, neurotoxicity, hypoaesthesia, peripheral motor neuropathy, neuralgia, polyneuropathy, and oral hypoesthesia. The median time to onset of peripheral neuropathy was 1.3 months (range: up to ~29 months). Of patients experiencing peripheral neuropathy, over one-fourth had complete resolution, and some had partial improvement (decrease in severity by one or more grades from the worst grade) at last follow-up. Peripheral neuropathy led to mirvetuximab soravtansine discontinuation in a small percentage of patients.

• Pulmonary toxicity: Severe, life-threatening, or fatal interstitial lung disease, including pneumonitis, may occur with mirvetuximab soravtansine. Pneumonitis occurred in 10% of patients, including rare grade 3 and 4 events. One fatality due to respiratory failure in the setting of pneumonitis and lung metastases was reported. In rare cases, pneumonitis resulted in dose reduction, treatment interruptions, or permanent discontinuation. Signs/symptoms of pneumonitis may include hypoxia, cough, dyspnea, or interstitial infiltrates on radiologic exams.

Other warnings/precautions:

• Appropriate use: Select patients for treatment based on folate receptor-alpha (FR-alpha) tumor expression. Information on approved tests for measurement of FR-alpha expression may be found at http://www.fda.gov/companiondiagnostics.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous [preservative free]:

Elahere: Mirvetuximab soravtansine-gynx 100 mg/20 mL (20 mL)

Generic Equivalent Available: US

Pricing: US

Solution (Elahere Intravenous)

100 mg/20 mL (per mL): $380.66

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Prescribing and Access Restrictions

Mirvetuximab soravtansine is available through specialty pharmacies/distributors and various specialty institutions/accounts. Examples from the manufacturer may be found at https://www.elaherehcp.com/pdf/elahere-ordering-information-sheet.pdf.

Administration: Adult

IV: Administer as an IV infusion only, using a 0.2- or 0.22-micron polyethersulfone (PES) in-line filter. Do not substitute other membrane materials. Visually inspect infusion bag for particulate matter and discoloration prior to administration. Administer premedications prior to mirvetuximab soravtansine administration. If refrigerated, allow the infusion bag to reach room temperature prior to administration.

Administer the initial dose at a rate of 1 mg/minute. If 30 minutes at a rate of 1 mg/minute is well tolerated, increase infusion rate to 3 mg/minute. If 30 minutes at 3 mg/minute is well tolerated, increase infusion rate to 5 mg/minute. If no infusion-related reactions occur with the previous dose, subsequent infusions should be started at the maximally tolerated rate and may be increased up to a maximum infusion rate of 5 mg/minute, as tolerated. Flush infusion line with D5W after infusion to ensure delivery of the dose; do not use any other IV fluids for flushing.

Mirvetuximab soravtansine is associated with a moderate emetic potential; antiemetics are recommended to prevent nausea and vomiting.

Hazardous Drugs Handling Considerations

Hazardous agent (NIOSH [group 1]).

Use appropriate precautions for receiving, handling, storage, preparation, dispensing, transporting, administration, and disposal. Follow NIOSH and USP 800 recommendations and institution-specific policies/procedures for appropriate containment strategy (NIOSH 2016; USP-NF 2020).

Use: Labeled Indications

Ovarian cancer, platinum-resistant, folate receptor-alpha positive (epithelial ovarian, fallopian tube, or primary peritoneal cancer): Treatment of folate receptor-alpha positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer in adults who have received one to three prior systemic treatment regimens (select patients for therapy based on an approved test).

Medication Safety Issues

Sound-alike/look-alike issues:

Elahere may be confused with Enhertu.

Mirvetuximab soravtansine may be confused with brentuximab vedotin, cetuximab, margetuximab, mirikizumab, mogamulizumab, mosunetuzumab, moxetumomab pasudotox, rituximab, siltuximab, ublituximab.

High alert medication:

This medication is in a class the Institute for Safe Medication Practices (ISMP) includes among its list of drug classes which have a heightened risk of causing significant patient harm when used in error.

Metabolism/Transport Effects

Substrate of CYP3A4 (minor), P-glycoprotein/ABCB1 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

CYP3A4 Inhibitors (Strong): May increase the serum concentration of Mirvetuximab Soravtansine. Risk C: Monitor therapy

Efgartigimod Alfa: May diminish the therapeutic effect of Fc Receptor-Binding Agents. Risk C: Monitor therapy

Rozanolixizumab: May diminish the therapeutic effect of Fc Receptor-Binding Agents. Risk C: Monitor therapy

Reproductive Considerations

Verify pregnancy status prior to treatment initiation in patients who could become pregnant.

Patients who could become pregnant should use effective contraception during therapy and for 7 months after the last mirvetuximab soravtansine dose.

Pregnancy Considerations

Animal reproduction studies have not been conducted.

Based on the mechanism of action, in utero exposure to mirvetuximab soravtansine may cause fetal harm. Mirvetuximab soravtansine is an antibody-drug conjugate that includes a monoclonal antibody component (IgG) and a small molecule anti-tubulin agent DM4. DM4 is genotoxic and acts on actively dividing cells. Human IgG crosses the placenta. Fetal exposure is dependent upon the IgG subclass, maternal serum concentrations, placental integrity, newborn birth weight, and gestational age. The lowest exposure would be expected during the period of organogenesis and the highest during the third trimester (Clements 2020; Palmeira 2012; Pentsuk 2009).

Breastfeeding Considerations

It is not known if mirvetuximab soravtansine is present in breast milk.

Mirvetuximab soravtansine is an antibody-drug conjugate that includes a monoclonal antibody component (IgG). Human IgG is present in breast milk; concentrations are dependent upon IgG subclass and postpartum age (Anderson 2021).

Due to the potential for serious adverse reactions in the breastfed infant, the manufacturer recommends that breastfeeding be discontinued during therapy and for 1 month after the last mirvetuximab soravtansine dose.

Monitoring Parameters

Folate receptor-alpha tumor expression. CBC with differential and serum chemistries (as clinically indicated). Verify pregnancy status prior to treatment initiation (in patients who could become pregnant). Ophthalmic exam including visual acuity and slit lamp exam prior to treatment initiation, every other cycle for the first 8 cycles, and as clinically indicated. Monitor for ocular toxicity (promptly refer to an eye care professional for new or worsening ocular signs and symptoms). Monitor for sings/symptoms of pneumonitis (eg, hypoxia, cough, dyspnea, or interstitial infiltrates on radiologic exams); assess appropriately to rule out other causes of pulmonary symptoms (eg, infectious, neoplastic, and/or other causes). Monitor for signs/symptoms of neuropathy (eg, paresthesia, tingling or a burning sensation, neuropathic pain, muscle weakness, or dysesthesia). Monitor for signs/symptoms of infusion reactions.

The American Society of Clinical Oncology hepatitis B virus (HBV) screening and management provisional clinical opinion (ASCO [Hwang 2020]) recommends HBV screening with hepatitis B surface antigen, hepatitis B core antibody, total Ig or IgG, and antibody to hepatitis B surface antigen prior to beginning (or at the beginning of) systemic anticancer therapy; do not delay treatment for screening/results. Detection of chronic or past HBV infection requires a risk assessment to determine antiviral prophylaxis requirements, monitoring, and follow-up.

Mechanism of Action

Mirvetuximab soravtansine is an antibody-drug conjugate which consists of 3 components, a folate receptor alpha (FRα)-directed monoclonal antibody (IgG1 subtype), a small molecule anti-tubulin agent DM4 (a maytansine derivative), and a linker that covalently attaches DM4 to the mirvetuximab antibody. The antibody portion is a chimeric IgG1 directed against folate receptor alpha (FRα); DM4 is a microtubule inhibitor attached to the antibody via a cleavable linker. Upon binding to FRα, mirvetuximab soravtansine is internalized and then intracellularly releases DM4 via proteolytic cleavage. DM4 disrupts the microtubule network within the cell, resulting in cell cycle arrest and apoptosis.

Pharmacokinetics (Adult Data Unless Noted)

Distribution: Vd_ss: 2.63 L.

Protein binding: DM4 and S-methyl DM4: >99%; to plasma proteins.

Metabolism: The monoclonal antibody portion of mirvetuximab soravtansine is expected to be catabolized into small peptides. Unconjugated DM4 and S-methyl DM4 undergo hepatic metabolism via CYP3A4; DM4 and S-methyl DM4 are the main circulating metabolites, accounting for ~0.4% and ~1.4%, of mirvetuximab soravtansine AUC’s, respectively.

Half-life elimination: Mirvetuximab soravtansine: 4.8 days; unconjugated DM4 (metabolite): 2.8 days; S-methyl DM4 (metabolite): 5 days.

Time to peak: Mirvetuximab soravtansine: Near the end of infusion; unconjugated DM4 (metabolite): second day after administration; S-methyl DM4 (metabolite): ~3 days after administration.

Excretion: S-methyl DM4 and DM4-sulfo-SPDB-lysine are the main metabolites detected in urine within 24 hours of infusion.

Clearance: Mirvetuximab soravtansine: 18.9 mL/hour; unconjugated DM4 (metabolite): 13.8 L/hour; S-methyl DM4 (metabolite): 4.3 L/hour.

<800> Hazardous Drugs—Handling in Healthcare Settings. United States Pharmacopeia and National Formulary (USP 43-NF 38). United States Pharmacopeia Convention; 2020:74-92.
Anderson PO. Monoclonal antibodies during breastfeeding. Breastfeed Med. 2021;16(8):591-593. doi:10.1089/bfm.2021.0110 [PubMed 33956488]
Clements T, Rice TF, Vamvakas G, et al. Update on transplacental transfer of IgG subclasses: impact of maternal and fetal factors. Front Immunol. 2020;11:1920. doi:10.3389/fimmu.2020.01920 [PubMed 33013843]
Elahere (mirvetuximab soravtansine) [prescribing information]. Waltham, MA: ImmunoGen, Inc; November 2022.
Griggs JJ, Bohlke K, Balaban EP, et al. Appropriate systemic therapy dosing for obese adult patients with cancer: ASCO guideline update. J Clin Oncol. 2021:39(18):2037-2048. doi:10.1200/JCO.21.00471 [PubMed 33939491]
Hwang JP, Feld JJ, Hammond SP, et al. Hepatitis B virus screening and management for patients with cancer prior to therapy: ASCO provisional clinical opinion update. J Clin Oncol. 2020;38(31):3698-3715. doi:10.1200/JCO.20.01757 [PubMed 32716741]
Matulonis UA, Lorusso D, Oaknin A, et al. Efficacy and safety of mirvetuximab soravtansine in patients with platinum-resistant ovarian cancer with high folate receptor alpha expression: results from the SORAYA study. J Clin Oncol. 2023;41(13):2436-2445. doi:10.1200/JCO.22.01900 [PubMed 36716407]
Moore KN, Angelergues A, Konecny GE, et al; Gynecologic Oncology Group Partners and the European Network of Gynaecological Oncological Trial Groups. Mirvetuximab soravtansine in FRα-positive, platinum-resistant ovarian cancer. N Engl J Med. 2023;389(23):2162-2174. doi:10.1056/NEJMoa2309169 [PubMed 38055253]
Palmeira P, Quinello C, Silveira-Lessa AL, Zago CA, Carneiro-Sampaio M. IgG placental transfer in healthy and pathological pregnancies. Clin Dev Immunol. 2012;2012:985646. doi:10.1155/2012/985646 [PubMed 22235228]
Pentsuk N, van der Laan JW. An interspecies comparison of placental antibody transfer: new insights into developmental toxicity testing of monoclonal antibodies. Birth Defects Res B Dev Reprod Toxicol. 2009;86(4):328-344. doi:10.1002/bdrb.20201 [PubMed 19626656]
US Department of Health and Human Services; Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health. NIOSH notice. https://www.cdc.gov/niosh/docs/2016-161/default.html. Updated May 9, 2023. Accessed May 17, 2023.
US Department of Health and Human Services; Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health. NIOSH list of antineoplastic and other hazardous drugs in healthcare settings 2016. https://www.cdc.gov/niosh/docs/2016-161/. Updated September 2016. Accessed November 16, 2022.

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Mirvetuximab soravtansine: Drug information