Folate Receptor Alpha (FRA) Expression Remains Unchanged in Epithelial Ovarian and Endometrial Cancer after Chemotherapy

Abstract

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Highlights

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Both epithelial ovarian and endometrial cancer demonstrate high expression of FRA (folate receptor alpha) compared to normal ovarian and endometrial tissue

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FRA expression is not altered by chemotherapy exposure at interval debulking surgery nor at recurrence

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Immunohistochemical FRA staining at diagnosis can guide the decision whether to use FRA targeted therapy upon recurrence

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Objective

Based on its expression profile, folate receptor alpha (FRA) is an attractive candidate for targeted diagnostics and therapeutics. However, applicability of these agents in residual or recurrent disease could be influenced by chemotherapy. We evaluated whether chemotherapy modified FRA expression in non-mucinous epithelial ovarian (EOC) and endometrial carcinoma (EC).

Methods

FRA staining was evaluated by immunohistochemistry, using MAb 26B3, in 81 patients (41 EOCs, 40 ECs) and 17 control tissues (5 benign ovarian cysts, 5 normal ovarian, 7 normal endometrial tissues). Chemotherapy effect was evaluated in 42 patients (30 paired samples at primary and interval debulking surgery, 12 from primary and recurrent disease). FRA expression was assessed using a semi-quantitative staining algorithm, the M-score (range 0-50).

Conclusions

This study shows no significant difference in FRA expression after chemotherapy, strengthening the rationale for FRA targeted diagnostics and therapeutics in FRA expressing tumors, whether newly diagnosed or at recurrence.