Given that access to ophthalmologists can be a significant bottleneck for patients, it is acceptable and practical for routine monitoring of mirvetuximab-related ocular side effects to be managed by optometrists. This pragmatic approach improves accessibility while ensuring patient safety.

For ovarian cancer patients experiencing significant ocular side effects from the ADC mervituximab, switching the dosing schedule from every three weeks to every four weeks can resolve the toxicity by allowing an extra week for recovery.

GYN oncology nurses are accustomed to GI and hematologic side effects. With mirvetuximab, they must now manage eye-related issues, requiring patient education on prophylactic eye drops and coordination with ophthalmologists for regular exams.

Nurses can proactively educate patients that if ocular side effects occur, they will likely manifest around the second cycle, between days 10 and 14. This specific timing helps manage patient anxiety and ensures prompt reporting and intervention.

For required ocular monitoring with certain ADCs, patients do not need to see a specialist ophthalmologist. An optometrist, including those at accessible and lower-cost retail locations, is fully qualified to perform the necessary exams. This practical tip helps mitigate financial toxicity and improves patient access to care.

When managing ocular toxicity from the ADC mirvetuximab, clinicians advocate for delaying the subsequent dose to allow the cornea to heal naturally. This approach is often preferred over an immediate dose reduction, which might unnecessarily compromise the treatment's efficacy.

The onset of ocular symptoms from mervituximab is highly predictable, almost always starting between days 10 and 14 of the second treatment cycle. Proactively warning patients about this specific timeline can reduce their anxiety if and when symptoms appear.

The ocular toxicity seen with the folate-targeted ADC mirvetuximab is not due to folate receptors in the eye. It is theorized to be caused by micropinocytosis, an alternative mechanism where the drug is non-specifically taken up by normal corneal cells, representing an off-target, off-tumor toxicity.

Managing side effects of antibody-drug conjugates is not one-size-fits-all. Sazetuzumab-govatecan requires managing GI issues, while Datopotamab-deruxtecan has unique risks like ophthalmologic problems and ILD, necessitating pre-treatment specialist evaluation. Proactive patient education and tailored mitigation are key to maintaining treatment continuity and efficacy.