Research Papers: Pathology:

Concordance of folate receptor-α expression between biopsy, primary tumor and metastasis in breast cancer and lung cancer patients

Leonora S.F. Boogerd, Martin C. Boonstra, Ann-Jean Beck, Ayoub Charehbili, Charlotte E.S. Hoogstins, Hendrica A.J.M. Prevoo, Sunil Singhal, Philip S. Low, Cornelis J.H. van de Velde and Alexander L. Vahrmeijer _

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Oncotarget. 2016; 7:17442-17454. https://doi.org/10.18632/oncotarget.7856

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Leonora S.F. Boogerd1,*, Martin C. Boonstra1,*, Ann-Jean Beck1, Ayoub Charehbili1, Charlotte E.S. Hoogstins1, Hendrica A.J.M. Prevoo1, Sunil Singhal2, Philip S. Low3, Cornelis J.H. van de Velde1 and Alexander L. Vahrmeijer1

1 Department of Surgery, Leiden Univeristy Medical Center, Leiden, The Netherlands

2 Department of Thoracic Surgery, Hospital of The University of Pennsylvania, Philadelphia, PA, USA

3 Department of Chemistry and Center for Drug Discovery, Purdue University, West Lafayette, IN, USA

* These authors have contributed equally to this work

Correspondence to:

Alexander L. Vahrmeijer, email:

Keywords: diagnosis, personalized medicine, targeting, oncology, biomarker, Pathology Section

Received: August 05, 2015 Accepted: January 31, 2016 Published: March 02, 2016


Folate receptor alpha (FRα) is known to be upregulated in a variety of cancers, including non-small cell lung cancer (NSCLC) and breast cancer. To ensure reliable implementation of diagnostic- and therapeutic agents, concordance of FRα expression between biopsy, primary tumor and metastases is important. Using immunohistochemistry (Mab 26B3.F2) these concordances were investigated in 60 NSCLC and 40 breast cancer patients. False positivity of FRα expression on breast and lung cancer biopsies was limited to less than 5%. In NSCLC, FRα expression was shown in 21/34 adenocarcinomas and 4/26 squamous cell carcinomas (SCC). Concordance of FRα expression between biopsy and primary tumor was achieved in respectively 83% and 91% of adenocarcinomas and SCCs. Approximately 80% of all local and distant metastases of NSCLC patients showed concordant FRα expression as their corresponding primary tumor. In breast cancer, FRα positivity was shown in 12/40 biopsies, 20/40 lumpectomies and 6/20 LN metastases, with concordance of 68% between biopsy and primary tumor and 60% between primary tumor and LN metastases. In conclusion, this study shows high concordance rates of FRα expression between biopsies and metastases compared to primary NSCLC and breast cancers, underscoring the applicability of FRα-targeted agents in these patients.

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