Folate Receptor Alpha Positive Cancer
- Elahere is an FDA-approved drug that specifically targets ovarian cancer cells with folate receptors, minimizing damage to healthy cells, extending survival and slowing the spread of the disease.
- Folate receptor-positive’ ovarian means that the cancer cells have a large amount of a special protein that fuels their growth.
- This type of cancer can become platinum-resistant, meaning it will stop responding to chemotherapy containing the drug platinum.
- Doctors can use a free, specialized test known as immunohistochemistry (IHC) to determine if the cancer has a high enough amount of the folate receptor protein to respond well to Elahere.
The FDA has give full approval for Elahere to treat ovarian cancers with high FR-alpha expression, also known as folate receptor-positive, that is characterized by the presence of folate receptors on the surface of cancer cells.
Read MoreWhat is Folate Receptor?
Folate receptors are proteins that act like “doors” on the surface of cells, allowing the entry of a vitamin called folate (also known as vitamin B9) into the cells. Folate is essential for cell growth and division, including both healthy cells and cancer cells. In folate receptor ovarian cancer, these receptors are found in higher amounts on the surface of cancer cells compared to normal cells. The presence of folate receptors on ovarian cancer cells is significant because it allows doctors to use targeted therapies that specifically attack cancer cells while sparing healthy cells.What are the benefits of Elahere?
The MIRASOL Study compared Elahere with standard chemotherapy in patients with platinum-resistant ovarian cancer who had already undergone up to three different treatments.
The trial, involving 453 patients, primarily looks at how long patients live without their cancer worsening. It also examines overall survival and response to treatment.
Final results showed:
- It reduced the chances of death compared to chemotherapy by 33%. Patients taking Elahere lived for an average of 17 months compared to about 13 months for the patients on chemotherapy.
- It reduced the chance of the cancer progressing by 35%. Patients on Elahere went nearly 6 months without their cancer spreading compared to 4 months for the patients on chemotherapy.
- More than 40% of patients taking Elahere saw their tumors shrink — and for 5% they disappeared completely.
- Elahere was also better tolerated than chemotherapy. Very few patients in the study had to stop taking it because of side effects.
Based on the final results of this study, the FDA gave Elahere full approval, marking the first time ever that there is a drug offering meaningful, life-extending benefits for folate receptor-positive ovarian cancer, even if there cancer has returned, and even if they have not responded to chemotherapy.
How do I Know if my Cancer Is Folate Receptor Positive?
“We need a sample or a piece of tissue from your tumor, and that can either be from your upfront surgery if that tissue is still available or can do a biopsy (if your cancer has come back), and then send that tissue off for testing to see whether or not your tumor expresses this folate receptor,” Dr. Yasmin Lyons, assistant professor in the division of gynecologic oncology at The University of Texas Health Science Center at San Antonio told SurvivorNet.
Ovarian cancers are not regularly tested for folate receptor positivity. FRα protein levels are quantified using a special test called immunohistochemistry (IHC). As of now, IHC may not be routinely performed as part of ovarian cancer workup.
However, ImmunoGen has partnered with the cancer laboratory testing company, NeoGenomics, to launch a free-of-cost FRα testing program, called FR-ASSIST.
Any patient with a diagnosis of ovarian cancer without prior FRα testing who resides and receives treatment within the USA is eligible to receive a free IHC for the protein through NeoGenomics. However, your oncologist may need to request this test for you by filling out a simple form.
Other laboratory testing companies, such as Labcorp, offers immunohistochemistry (IHC) testing, also free of charge to eligible patients.
To be eligible for the Sponsored Testing Program, patients must meet all of the following criteria to be eligible:
- A patient has epithelial ovarian cancer, fallopian tube or primary peritoneal cancer
- A patient lives and receives treatment in the United States or a US Territory
- A patient does not have a known FRα expression from a previous test
- A patient has not previously been tested under this program
- A patient’s physician has determined that the test is clinically appropriate for the individual patient
FRα Positivity: Why Does It Matter?
Folate receptors found on ovarian cancer cells are important because they enable doctors to use targeted therapies that focus on attacking only the cancer cells, leaving the healthy cells unharmed.
One such targeted therapy is using drugs called folate receptor inhibitors, such as Elahare (drug name mirvetuximab soravtansine). As of today, Elahare is the first and only FDA-approved FRα-targeted treatment for platinum-resistant ovarian cancer though there is a substantial pipeline of agents being developed that target the folate receptor.
These drugs are designed to block the folate receptors on cancer cells, preventing the entry of folate and depriving the cancer cells of a crucial nutrient for their growth and division. By targeting folate receptors, these treatments aim to slow down or stop the growth of the ovarian cancer.
Targeted therapies like folate receptor inhibitors are an important area of research and treatment for ovarian cancer, as they can potentially offer more effective and less harmful treatment options for patients with folate receptor-positive ovarian cancer.
Questions to Ask Your Doctor
- Should my cancer be tested for the FRα protein?
- Should you order an immunohistochemistry (IHC) test?
- What additional tests might I need?
- Am I eligible for Elahere?
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