Characterization of folate receptor alpha (FRα) expression in archival tumor and biopsy samples from relapsed epithelial ovarian cancer patients: A phase I expansion study of the FRα-targeting antibody-drug conjugate mirvetuximab soravtansine Journal Article


Authors: Martin, L. P.; Konner, J. A.; Moore, K. N.; Seward, S. M.; Matulonis, U. A.; Perez, R. P.; Su, Y.; Berkenblit, A.; Ruiz-Soto, R.; Birrer, M. J.
Article Title: Characterization of folate receptor alpha (FRα) expression in archival tumor and biopsy samples from relapsed epithelial ovarian cancer patients: A phase I expansion study of the FRα-targeting antibody-drug conjugate mirvetuximab soravtansine
Abstract: Purpose To characterize folate receptor alpha (FRα) expression in archival and fresh biopsy tumor samples from relapsed ovarian cancer patients. Methods Patients with ovarian tumors amenable to biopsy were eligible to enroll. Eligibility included a minimum requirement of FRα positivity in archival tumor samples (≥ 25% of cells with ≥ 2 + staining intensity). Patients received mirvetuximab soravtansine at 6 mg/kg once every 3 weeks. Core needle biopsies were collected before and after treatment and FRα levels assessed by immunohistochemistry. Descriptive statistics were used to summarize the association between receptor expression and response. Results Twenty-seven heavily pre-treated patients were enrolled. Six individuals (22%) did not have evaluable pre-treatment biopsies due to insufficient tumor cells. The concordance of FRα expression in archival and biopsy tissues was 71%, and no major shifts in receptor expression were seen in matched pre- and post-treatment biopsy samples. Adverse events were generally mild (≤ grade 2) with keratopathy (48%), fatigue (44%), diarrhea, and blurred vision (each 37%) being the most common treatment-related toxicities. The confirmed objective response rate (ORR) was 22%, including two complete responses and four partial responses. Superior efficacy measures were observed in the subset of patients with the highest FRα levels (ORR, 31%; progression-free survival, 5.4 months). Conclusion Concordance of FRα expression in biopsy versus archival tumor samples suggests that archival tissue can reliably identify patients with receptor-positive tumors and is appropriate for patient selection in mirvetuximab soravtansine clinical trials. Regardless of the tissue source analyzed, higher FRα expression was associated with greater antitumor activity. © 2017 The Authors
Keywords: immunohistochemistry; adult; cancer chemotherapy; cancer survival; clinical article; human tissue; protein expression; aged; middle aged; clinical trial; fatigue; cancer recurrence; diarrhea; drug efficacy; drug withdrawal; ovarian cancer; ovarian neoplasms; protein analysis; progression free survival; tumor biopsy; antineoplastic activity; biopsy; monoclonal antibody; hypokalemia; biosynthesis; immunology; needle biopsy; ovary carcinoma; phase 1 clinical trial; blurred vision; maytansine; electrocorticography; folate receptor alpha; neoplasms, glandular and epithelial; molecularly targeted therapy; antibody conjugate; immunoconjugates; folate receptor 1; molecular targeted therapy; organizing pneumonia; fallopian tube; antibodies, monoclonal, humanized; antibody-drug conjugate; humans; human; female; priority journal; article; analogs and derivatives; mirvetuximab soravtansine; keratopathy
Journal Title: Gynecologic Oncology
Volume: 147
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2017-11-01
Start Page: 402
End Page: 407
Language: English
DOI: 10.1016/j.ygyno.2017.08.015
PUBMED: 28843653
PROVIDER: scopus
PMCID: PMC6893864
DOI/URL:
Notes: Article -- Export Date: 1 December 2017 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Jason Konner
    155 Konner