High Expression of Folate Receptor Alpha (FOLR1) is Associated With Aggressive Tumor Behavior, Poor Response to Chemoradiotherapy, and Worse Survival in Rectal Cancer

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Title:	High Expression of Folate Receptor Alpha (FOLR1) is Associated With Aggressive Tumor Behavior, Poor Response to Chemoradiotherapy, and Worse Survival in Rectal Cancer
Authors:	Chen, Chih-I Li, Wan-Shan Chen, Hsin-Pao Liu, Kuang-Wen Tsai, Chia-Jen Hung, Wei-Ju Yang, Ching-Chieh
Contributors:	E-Da Hospital I Shou University National Sun Yat Sen University Chi Mei Hospital Chung Hua University Department of Pharmacy, Chia Nan University of Pharmacy & Science
Keywords:	preoperative chemoradiotherapy mirvetuximab soravtansine epithelial ovarian binding-protein chemotherapy carcinoma carcinogenesis antibody target
Date:	2022
Issue Date:	2023-12-11 14:06:07 (UTC+8)
Publisher:	SAGE PUBLICATIONS INC
Abstract:	Objectives: Recently, molecular medicine targeting Folate Receptor Alpha (FOLR1), which mediates intracellular folate uptake and tumor cell proliferation, has been identified in several malignancies. However, the association between FOLR1 expression and rectal cancer remains unclear. Methods: Immunostaining of FOLR1 was performed on biopsy specimens from 172 rectal cancer patients undergoing preoperative chemoradiotherapy (CRT). FOLR1 expression was measured and divided into low (0+-2+) or high (3+-4+) level. Correlations between FOLR1 status and clinicopathologic features, tumor regression grade, disease-specific survival (DSS), local recurrence-free survival, and metastasis-free survival (MeFS) were analyzed, retrospectively. Results: High FOLR1 expression was significantly associated with advanced post-treatment tumor and nodal status (T3-4; N1-2, P = .001), vascular invasion (P = .042), perineural invasion (P = .012), and poor regression change after CRT (P = .001). In uni- and multi-variable survival analysis, FOLR1 overexpression remained a significant predictor of lower DSS (hazard ratio [HR], 2.328; 95% confidence interval [CI], 1.014-5.344; P = .046) and MeFS (HR, 2.177; 95% CI, 1.000-1.1286; P = .050). Conclusion: These results indicate that high FOLR1 status is associated with aggressive tumor behavior, poor response to CRT, and worse survival. Therefore, FOLR1 expression at initial biopsy may be useful in predicting outcomes and also be a target for the exploration of FOLR1-based therapeutic agents.
Relation:	TECHNOLOGY IN CANCER RESEARCH & TREATMENT, v.21, January-December 2022
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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