Dr Lynam on the Importance of FRα Expression Testing in Ovarian Cancer

“In my clinical practice, I do test folate receptor–alpha expression early, because that's an important piece of information that we want to have for patients who are developing disease recurrence, and helps us inform and decide if we have this tool to be able to determine what newer options we have available to [patients].”

Sarah Lynam, MD, an assistant professor in the Division of Gynecologic Oncology in the Department of Reproductive Biology at Case Western Reserve University School of Medicine, and an attending physician in the Division of Gynecologic Oncology at the Seidman Cancer Center at the University Hospitals Cleveland Medical Center, highlighted treatment decision-making considerations in clinical practice regarding mirvetuximab soravtansine-gynx (Elahere) for the treatment of patients with ovarian cancer.

Treatment decision-making for patients with ovarian cancer depends on testing, which helps determine patients’ folate receptor–alpha (FRα) expression, Lynam began. She noted that this is essential to determine early on because it’s currently unknown when patients will develop resistance to platinum-based chemotherapy. A significant number of patients eventually develop platinum resistance, either following first-line therapy or after subsequent exposure to a platinum-based regimen, she explained.

Moreover, Lynam noted that in her clinical practice, she tests for FRα expression early in the disease course. The test plays a key role in planning for patients who could develop disease recurrence and helps inform and determine newer treatment options that could be available, she asserted. Since mirvetuximab soravtansine gained full approval by the FDA in March 2024, the ovarian cancer landscape now has an agent that could improve outcomes regarding overall survival, particularly in patients with platinum resistance, she added. Therefore, identifying patients’ FRα expression early on is important, especially for those who have not received multiple prior lines of therapy and tend to respond well to mirvetuximab soravtansine, which is reflective of the data from the phase 3 MIRASOL trial (NCT04209855), she concluded.