Folate receptor alpha expression associates with improved disease-free survival in triple negative breast cancer patients.

Folate receptor alpha expression associates with improved disease-free survival in triple negative breast cancer patients.

Norton, Nadine;Youssef, Bahaaeldin;Hillman, David W;Nassar, Aziza;Geiger, Xochiquetzal J;Necela, Brian M;Liu, Heshan;Ruddy, Kathryn J;Polley, Mei-Yin C;Ingle, James N;Couch, Fergus J;Perez, Edith A;Liu, Minetta C;Carter, Jodi M;Leon-Ferre, Roberto A;Boughey, Judy C;Somers, Elizabeth B;Kalari, Krishna R;Visscher, Daniel W;Goetz, Matthew P;Knutson, Keith L;
npj breast cancer 2020 Vol. 6 pp. 4
324
norton2020folatenpj

Abstract

Triple negative breast cancer (TNBC) comprises 15-20% of all invasive breast cancer and is associated with a poor prognosis. As therapy options are limited for this subtype, there is a significant need to identify new targeted approaches for TNBC patient management. The expression of the folate receptor alpha (FRα) is significantly increased in patients with TNBC and is therefore a potential biomarker and therapeutic target. We optimized and validated a FRα immunohistochemistry method, specific to TNBC, to measure FRα expression in a centrally confirmed cohort of 384 patients with TNBC in order to determine if expression of the protein is associated with invasive disease-free survival (IDFS) and overall survival (OS). The FRα IHC demonstrated exceptional performance characteristics with low intra- and interassay variability as well as minimal lot-to-lot variation. FRα expression, which varied widely from sample to sample, was detected in 274 (71%) of the TNBC lesions. In a multivariable model adjusted for baseline characteristics, FRα expression was associated with improved IDFS (HR = 0.63,  = 0.01) but not with OS. The results demonstrate the potential of targeting the FRα in the majority of TNBC patients and suggest that variable expression may point to a need to stratify on FRα expression in clinical studies.

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