Related Experiment Video
Updated: May 11, 2026
Ex Vivo Culture of Primary Human Fallopian Tube Epithelial Cells
Published on: May 9, 2011
Analysis of real world FRα testing in ovarian, fallopian tube, and primary peritoneal cancers
Rebecca A Previs1, Kyle C Strickland2, Zachary Wallen3
1Labcorp, Durham, NC, USA; Duke University Medical Center, Duke Cancer Institute, Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Durham, NC, USA.
Background:
Epithelial ovarian cancer (EOC) remains a significant challenge in gynecologic oncology, particularly in the context of platinum-resistant disease. Mirvetuximab soravtansine (MIRV), was approved after trials revealed favorable response and survival outcomes. MIRV targets folate receptor alpha (FRα), a cell-surface receptor that is overexpressed in EOC and has been associated with aggressive disease phenotypes.
Methods:
This retrospective study analyzed 425 patient samples tested for FRα using the VENTANA® FOLR1 RxDx immunohistochemical assay. The patient cohort included cases with high grade serous carcinoma predominantly, tested across various anatomical sites. Statistical analysis examined the correlation between FRα positivity and clinical parameters such as tumor site and histology.
Results:
FRα was highly expressed in 36.3 % of the cases, with a significant association between FRα positivity and high grade serous ovarian histology. Tumor samples from the ovary, fallopian tube, adnexa, and dominant pelvic masses showed higher FRα positivity compared to metastatic sites (positive rates of 44.4 % vs 32.5 %, p = 0.02), highlighting the potential influence of tumor origin on expression of FRα. Time between sample collection and testing did not impact FRα expression, with sample testing spread over a median of 19.5 months post-collection. Eight patients had more than one specimen tested, of which 3 (37.5 %) had discordant results when a subsequent specimen was tested.
Conclusion:
Our results highlight a need for standardized protocols for FRα testing to ensure accurate biomarker evaluation across varied clinical settings. The heterogeneity in FRα expression, influenced by tumor histology and anatomical origin, warrant further investigation to optimize therapeutic outcomes.
Prior Presentation:
Preliminary findings from this study were previously presented in poster format at the Society of Gynecologic Oncology 2024 Annual Metting. We confirm that the submission complies with the journal requirements.
Insights
Folate receptor alpha (FRα) is highly expressed in 36.3% of epithelial ovarian cancer cases, particularly in high-grade serous histology. Tumor origin influences FRα expression, necessitating standardized testing for accurate biomarker evaluation.
Area of Science:
- Gynecologic Oncology
- Molecular Pathology
- Biomarker Discovery
Background:
- Epithelial ovarian cancer (EOC) presents a significant challenge, especially in platinum-resistant cases.
- Mirvetuximab soravtansine (MIRV) shows efficacy by targeting folate receptor alpha (FRα), a receptor overexpressed in EOC and linked to aggressive disease.
- FRα is a key target for novel therapeutics in EOC management.
Purpose of the Study:
- To analyze FRα expression in a large cohort of EOC patient samples.
- To investigate the correlation between FRα positivity and clinical parameters like tumor histology and anatomical site.
- To assess the impact of pre-analytical factors on FRα expression.
Main Methods:
- Retrospective analysis of 425 patient samples tested for FRα using immunohistochemistry (VENTANA® FOLR1 RxDx assay).
- Cohort predominantly included high-grade serous carcinoma across various anatomical sites.
- Statistical analysis to determine associations between FRα positivity and clinical factors.
Main Results:
- FRα was expressed in 36.3% of cases, with significant association to high-grade serous ovarian histology.
- Primary tumor sites (ovary, fallopian tube, adnexa) showed higher FRα positivity (44.4%) than metastatic sites (32.5%).
- No impact of time between sample collection and testing on FRα expression; however, 37.5% of patients with multiple specimens showed discordant results.
Conclusions:
- FRα expression is heterogeneous, influenced by tumor histology and anatomical origin.
- Standardized protocols for FRα testing are crucial for accurate biomarker evaluation in diverse clinical settings.
- Further research is warranted to optimize therapeutic strategies based on FRα expression variability.
