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Opinion|Videos|April 28, 2025

FRα Biomarker Testing in Patients With Ovarian Cancer

A panelist discusses how folate receptor alpha (FRα) expression testing plays a crucial role in determining eligibility for mirvetuximab soravtansine (an antibody-drug conjugate therapy), emphasizing the importance of comprehensive biomarker testing at diagnosis rather than piecemeal testing.

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Role of Folate Receptor Alpha Testing

Mirvetuximab soravtansine, an antibody-drug conjugate targeting FRα, represents the newest approved therapy in ovarian cancer. Testing considerations include the following:

  • Immunohistochemistry evaluation assesses the percentage of positive cells and staining intensity.
  • Optimal response predictors are cells with 2+ or greater staining intensity in 75% or more of tumor cells.
  • Testing should be integrated into comprehensive molecular profiling at diagnosis.
  • There is minimal spatial or temporal heterogeneity in ovarian cancer biomarkers, making initial testing generally reliable throughout treatment.

The NCCN recommends universal FRα testing as part of comprehensive biomarker assessment, which has shifted from individual tests to comprehensive panels performed at diagnosis.

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