Skip to main content

Potential for α-Folate Receptor-Targeted Treatment for Ovarian Cancer

  • Chapter
  • First Online:
Emerging Therapeutic Targets in Ovarian Cancer
  • 564 Accesses

Abstract

The majority of ovarian and a percentage of many other cancers express high levels of the folate receptor (FR). Folates and clinically approved antifolate drugs are largely transported into tumours and normal tissues via the high capacity reduced-folate carrier (RFC). A new generation of antifolates and folate–drug conjugates have been discovered that are preferentially transported via FRs and, because of highly restricted expression in normal tissues, they reach their targets selectively in tumours expressing the receptors. FRs are also being exploited by the development of therapeutic antibodies, folate-conjugated drug carriers and imaging agents. The preclinical and emerging clinical data demonstrate that the α-FR is an important therapeutic target in cancer with particular relevance in non-mucinous ovarian carcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Acharya G, Chang CL, et al. (2007). Immunomagnetic diffractometry for detection of diagnostic serum markers. J Am Chem Soc 129(51):15824–29.

    Article  PubMed  Google Scholar 

  • Allard JE, Risinger JI, et al. (2007). Overexpression of folate binding protein is associated with shortened progression-free survival in uterine adenocarcinomas. Gynecol Oncol 107(1): 52–57.

    Article  PubMed  CAS  Google Scholar 

  • Armstrong DK, Bicher A, et al. (2008). Exploratory phase II efficacy study of MORAb-003, a monoclonal antibody against folate receptor alpha, in platinum-sensitive ovarian cancer in first relapse. Proc Am Soc Clin Onc 26: Abstract 5500.

    Google Scholar 

  • Bagnoli M, Canevari S, et al. (2003). A step further in understanding the biology of the folate receptor in ovarian carcinoma. Gynecol Oncol 88(1 Pt 2):S140–S44.

    Article  PubMed  CAS  Google Scholar 

  • Bagnoli M, Tomassetti A, et al. (2000). Downmodulation of caveolin-1 expression in human ovarian carcinoma is directly related to alpha-folate receptor overexpression. Oncogene 19(41):4754–63.

    Article  PubMed  CAS  Google Scholar 

  • Basal E, Eghbali-Fatourechi GZ, et al. (2009). Functional folate receptor alpha is elevated in the blood of ovarian cancer patients. PLoS One 4(7):e6292.

    Article  PubMed  CAS  Google Scholar 

  • Bell-McGuinn KM, Konner J, et al. (2007). A phase I study of MORAb-003, a fully humanized monoclonal antibody against folate receptor alpha, in advanced epithelial ovarian cancer. Proc Am Soc Clin Onc 25: Abstract 5553.

    Google Scholar 

  • Birn H, Spiegelstein O, et al. (2005). Renal tubular reabsorption of folate mediated by folate binding protein 1. J Am Soc Nephrol 16(3):608–15.

    Article  PubMed  CAS  Google Scholar 

  • Bottero F, Tomassetti A, et al. (1993). Gene transfection and expression of the ovarian carcinoma marker folate binding protein on NIH/3T3 cells increases cell growth in vitro and in vivo. Cancer Res 53(23):5791–96.

    PubMed  CAS  Google Scholar 

  • Brown Jones M, Neuper C, et al. (2008). Rationale for folate receptor alpha targeted therapy in “high risk” endometrial carcinomas. Int J Cancer 123(7): 1699–1703.

    Article  PubMed  CAS  Google Scholar 

  • Bueno R, Appasani K, et al. (2001). The alpha folate receptor is highly activated in malignant pleural mesothelioma. J Thorac Cardiovasc Surg 121(2): 225–233.

    Article  PubMed  CAS  Google Scholar 

  • Campbell IG, Jones TA, et al. (1991). Folate-binding protein is a marker for ovarian cancer. Cancer Res 51(19):5329–38.

    PubMed  CAS  Google Scholar 

  • Coney LR, Mezzanzanica D, et al. (1994). Chimeric murine-human antibodies directed against folate binding receptor are efficient mediators of ovarian carcinoma cell killing. Cancer Res 54(9):2448–55.

    PubMed  CAS  Google Scholar 

  • Crippa F, Bolis G, et al. (1995). Single-dose intraperitoneal radioimmunotherapy with the murine monoclonal antibody I-131 MOv18: clinical results in patients with minimal residual disease of ovarian cancer. Eur J Cancer 31A(5):686–90.

    Article  PubMed  CAS  Google Scholar 

  • Dainty LA, Risinger JI, et al. (2007). Overexpression of folate binding protein and mesothelin are associated with uterine serous carcinoma. Gynecol Oncol 105(3): 563–570.

    Article  PubMed  CAS  Google Scholar 

  • Ebel W, Routhier EL, et al. (2007). Preclinical evaluation of MORAb-003, a humanized monoclonal antibody antagonizing folate receptor-alpha. Cancer Immun 7:6

    PubMed  Google Scholar 

  • Elgqvist J, Andersson H, et al. (2005). Therapeutic efficacy and tumor dose estimations in radioimmunotherapy of intraperitoneally growing OVCAR-3 cells in nude mice with (211) At-labeled monoclonal antibody MX35. J Nucl Med 46(11):1907–15.

    PubMed  CAS  Google Scholar 

  • Elnakat H, Ratnam M (2004). Distribution, functionality and gene regulation of folate receptor isoforms: implications in targeted therapy. Adv Drug Deliv Rev 56(8):1067–84.

    Article  PubMed  CAS  Google Scholar 

  • Figini M, Ferri R, et al. (2003). Reversion of transformed phenotype in ovarian cancer cells by intracellular expression of anti folate receptor antibodies. Gene Ther 10(12):1018–25.

    Article  PubMed  CAS  Google Scholar 

  • Fisher RE, Siegel BA, et al. (2008). Exploratory study of 99mTc-EC20 imaging for identifying patients with folate receptor-positive solid tumors. J Nucl Med 49(6):899–906.

    Article  PubMed  Google Scholar 

  • Forster MD, Ormerod MG, et al. (2007). Flow cytometric method for determining folate receptor expression on ovarian carcinoma cells. Cytometry A 71(11):945–50.

    PubMed  Google Scholar 

  • Franklin WA, Waintrub M, et al. (1994). New anti-lung-cancer antibody cluster 12 reacts with human folate receptors present on adenocarcinoma. Int J Cancer Suppl 8: 89–95.

    Article  PubMed  CAS  Google Scholar 

  • Gabizon A, Shmeeda H, et al. (2004). Tumor cell targeting of liposome-entrapped drugs with phospholipid-anchored folic acid-PEG conjugates. Adv Drug Deliv Rev 56(8):1177–92.

    Article  PubMed  CAS  Google Scholar 

  • Garin-Chesa P, Campbell I, et al. (1993). Trophoblast and ovarian cancer antigen LK26. Sensitivity and specificity in immunopathology and molecular identification as a folate-binding protein. Am J Pathol 142(2):557–67.

    PubMed  CAS  Google Scholar 

  • Gibbs DD, Theti DS, et al. (2005). BGC 945, a novel tumor-selective thymidylate synthase inhibitor targeted to alpha-folate receptor-overexpressing tumors. Cancer Res 65(24):11721–28.

    Article  PubMed  CAS  Google Scholar 

  • Hartmann LC, Keeney GL, et al. (2007). Folate receptor overexpression is associated with poor outcome in breast cancer. Int J Cancer 121(5): 938–942.

    Article  PubMed  CAS  Google Scholar 

  • Jackman AL, Theti DS, et al. (2004). Antifolates targeted specifically to the folate receptor. Adv Drug Deliv Rev 56(8):1111–25.

    Article  PubMed  CAS  Google Scholar 

  • Jain RK (2001). Delivery of molecular and cellular medicine to solid tumors. Adv Drug Deliv Rev 46(1–3):149–68.

    Article  PubMed  CAS  Google Scholar 

  • Kalli KR, Oberg AL, et al. (2008). Folate receptor alpha as a tumor target in epithelial ovarian cancer. Gynecol Oncol 108(3):619–26.

    Article  PubMed  CAS  Google Scholar 

  • Kamen BA, Capdevila A (1986). Receptor-mediated folate accumulation is regulated by the cellular folate content. Proc Natl Acad Sci USA 83(16):5983–87.

    Article  PubMed  CAS  Google Scholar 

  • Kamen BA, Wang MT, et al. (1988). Delivery of folates to the cytoplasm of MA104 cells is mediated by a surface membrane receptor that recycles. J Biol Chem 263(27):13602–09.

    PubMed  CAS  Google Scholar 

  • Kane MA, Waxman S (1989). Role of folate binding proteins in folate metabolism. Lab Invest 60(6):737–46.

    PubMed  CAS  Google Scholar 

  • Kelley KM, Rowan BG, et al. (2003). Modulation of the folate receptor alpha gene by the estrogen receptor: mechanism and implications in tumor targeting. Cancer Res 63(11):2820–28.

    PubMed  CAS  Google Scholar 

  • Kranz DM, Patrick TA, et al. (1995). Conjugates of folate and anti-T-cell-receptor antibodies specifically target folate-receptor-positive tumor cells for lysis. Proc Natl Acad Sci USA 92(20):9057–61.

    Article  PubMed  CAS  Google Scholar 

  • Leamon CP (2008). Folate-targeted drug strategies for the treatment of cancer. Curr Opin Investig Drugs 9(12):1277–86.

    PubMed  CAS  Google Scholar 

  • Leamon CP, Jackman AL (2008). Exploitation of the folate receptor in the management of cancer and inflammatory disease. Vitam Horm 79:203–33

    Article  PubMed  CAS  Google Scholar 

  • Leamon CP, Reddy JA, et al. (2007). Preclinical antitumor activity of a novel folate-targeted dual drug conjugate. Mol Pharm 4(5):659–67.

    Article  PubMed  CAS  Google Scholar 

  • Lee RJ, Low PS (1994). Delivery of liposomes into cultured KB cells via folate receptor-mediated endocytosis. J Biol Chem 269(5):3198–204.

    PubMed  CAS  Google Scholar 

  • Lee RJ, Low PS (1995). Folate-mediated tumor cell targeting of liposome-entrapped doxorubicin in vitro. Biochim Biophys Acta 1233(2):134–44.

    Article  PubMed  Google Scholar 

  • Low PS, Henne WA, et al. (2008). Discovery and development of folic-acid-based receptor targeting for imaging and therapy of cancer and inflammatory diseases. Acc Chem Res 41(1):120–29.

    Article  PubMed  CAS  Google Scholar 

  • Low PS, Kularatne SA (2009). Folate-targeted therapeutic and imaging agents for cancer. Curr Opin Chem Biol 13(3):256–62.

    Article  CAS  Google Scholar 

  • Mantovani LT, Miotti S, et al. (1994). Folate binding protein distribution in normal tissues and biological fluids from ovarian carcinoma patients as detected by the monoclonal antibodies MOv18 and MOv19. Eur J Cancer 30A(3):363–69.

    Article  PubMed  CAS  Google Scholar 

  • Markert S, Lassmann S, et al. (2008). Alpha-folate receptor expression in epithelial ovarian carcinoma and non-neoplastic ovarian tissue. Anticancer Res 28(6A):3567–72.

    PubMed  Google Scholar 

  • Matherly LH, Hou Z, et al. (2007). Human reduced folate carrier: translation of basic biology to cancer etiology and therapy. Cancer Metastasis Rev 26(1):111–28.

    Article  PubMed  CAS  Google Scholar 

  • Melani C, Figini M, et al. (1998). Targeting of interleukin 2 to human ovarian carcinoma by fusion with a single-chain Fv of antifolate receptor antibody. Cancer Res 58(18):4146–54.

    PubMed  CAS  Google Scholar 

  • Messmann R, Amato R, et al. (2007). A phase II study of FolateImmune (EC90 with GP1-0100 adjuvant followed by EC17) with low dose cytokines interleukin-2 (IL-2) and interferon-alpha (IFN-alpha) in patients with refractory or metastatic cancer. Proc Am Soc Clin Oncol 25(18S): Abstract 13516.

    Google Scholar 

  • Miotti S, Bagnoli M, et al. (2000). Interaction of folate receptor with signaling molecules lyn and G(alpha)(i-3) in detergent-resistant complexes from the ovary carcinoma cell line IGROV1. J Cell Sci 113(Pt 2):349–57.

    PubMed  CAS  Google Scholar 

  • Miotti S, Canevari S, et al. (1987). Characterization of human ovarian carcinoma-associated antigens defined by novel monoclonal antibodies with tumor-restricted specificity. Int J Cancer 39(3):297–303.

    Article  PubMed  CAS  Google Scholar 

  • Molthoff CF, Prinssen HM, et al. (1997). Escalating protein doses of chimeric monoclonal antibody MOv18 immunoglobulin G in ovarian carcinoma patients: a phase I study. Cancer 80(12 Suppl):2712–20.

    PubMed  CAS  Google Scholar 

  • Nakashima-Matsushita N, Homma T, et al. (1999). Selective expression of folate receptor beta and its possible role in methotrexate transport in synovial macrophages from patients with rheumatoid arthritis. Arthritis Rheum 42(8):1609–16.

    Article  PubMed  CAS  Google Scholar 

  • Ng C, Valenti M, et al. (2008). Efficacy and tolerability of the thymidylate synthase (TS) inhibitor, BGC 945 is mediated through its selective uptake via the alpha-folate receptor alpha-FR in IGROV-1 human tumor xenografts. Proc Am Assoc Can Res: Abstract 3289.

    Google Scholar 

  • Pan XQ, Wang H, et al. (2003). Antitumor activity of folate receptor-targeted liposomal doxorubicin in a KB oral carcinoma murine xenograft model. Pharm Res 20(3):417–22.

    Article  PubMed  CAS  Google Scholar 

  • Parker N, Turk MJ, et al. (2005). Folate receptor expression in carcinomas and normal tissues determined by a quantitative radioligand binding assay. Anal Biochem 338(2):284–93.

    Article  PubMed  CAS  Google Scholar 

  • Pillai RG, Forster M, et al. (2008). Imaging pharmacodynamics of the alpha-folate receptor-targeted thymidylate synthase inhibitor BGC 945. Cancer Res 68(10):3827–34.

    Article  PubMed  CAS  Google Scholar 

  • Ramaekers VT, Blau N (2004). Cerebral folate deficiency. Dev Med Child Neurol 46(12):843–51.

    Article  PubMed  Google Scholar 

  • Reddy JA, Haneline LS, et al. (1999). Expression and functional characterization of the beta-isoform of the folate receptor on CD34(+) cells. Blood 93(11):3940–48.

    PubMed  CAS  Google Scholar 

  • Ross JF, Wang H, et al. (1999). Folate receptor type beta is a neutrophilic lineage marker and is differentially expressed in myeloid leukemia. Cancer 85(2):348–57.

    Article  PubMed  CAS  Google Scholar 

  • Saba NF, Wang X, et al. (2009). Examining expression of folate receptor in squamous cell carcinoma of the head and neck as a target for a novel nanotherapeutic drug. Head Neck 31(4): 475–481.

    Article  PubMed  Google Scholar 

  • Salazar MD, Ratnam M (2007). The folate receptor: what does it promise in tissue-targeted therapeutics? Cancer Metastasis Rev 26(1):141–52.

    Article  PubMed  CAS  Google Scholar 

  • Sandoval RM, Kennedy MD, et al. (2004). Uptake and trafficking of fluorescent conjugates of folic acid in intact kidney determined using intravital two-photon microscopy. Am J Physiol Cell Physiol 287(2):C517–C26.

    Article  PubMed  CAS  Google Scholar 

  • Sanna E, Miotti S, et al. (2007). Binding of nuclear caveolin-1 to promoter elements of growth-associated genes in ovarian carcinoma cells. Exp Cell Res 313(7):1307–17.

    Article  CAS  Google Scholar 

  • Sausville E, Lorusso P, et al. (2007). A phase I study of EC145 administered weeks 1 and 3 of a 4-week cycle in patients with refractory solid tumors. Proc Am Soc Clin Onc 25(18S): 2577.

    Google Scholar 

  • Sega EI, Low PS (2008). Tumor detection using folate receptor-targeted imaging agents. Cancer Metastasis Rev 27(4):655–64.

    Article  PubMed  CAS  Google Scholar 

  • Shen F, Ross JF, et al. (1994). Identification of a novel folate receptor, a truncated receptor, and receptor type beta in hematopoietic cells: cDNA cloning, expression, immunoreactivity, and tissue specificity. Biochemistry 33(5):1209–15.

    Article  PubMed  CAS  Google Scholar 

  • Shen F, Wu M, et al. (1995). Folate receptor type gamma is primarily a secretory protein due to lack of an efficient signal for glycosylphosphatidylinositol modification: protein characterization and cell type specificity. Biochemistry 34(16):5660–65.

    Article  PubMed  CAS  Google Scholar 

  • Shia J, Klimstra, DS, et al. (2008). Immunohistochemical expression of folate receptor alpha in colorectal carcinoma: patterns and biological significance. Hum Pathol 39(4): 498–505.

    Article  PubMed  CAS  Google Scholar 

  • Smith AE, Pinkney M, et al. (2007). A novel monoclonal antibody for detection of folate receptor alpha in paraffin-embedded tissues. Hybridoma (Larchmt) 26(5):281–88.

    Article  CAS  Google Scholar 

  • Sun XL, Antony AC (1996). Evidence that a specific interaction between an 18-base cis-element in the 5-untranslated region of human folate receptor-alpha mRNA and a 46-kDa cytosolic trans-factor is critical for translation. J Biol Chem 271(41):25539–47.

    PubMed  CAS  Google Scholar 

  • Theti DS, Bavetsias V, et al. (2003). Selective delivery of CB300638, a cyclopenta[g]quinazoline-based thymidylate synthase inhibitor into human tumor cell lines overexpressing the alpha-isoform of the folate receptor. Cancer Res 63(13):3612–18.

    PubMed  CAS  Google Scholar 

  • Theti DS, Jackman AL (2004). The role of alpha-folate receptor-mediated transport in the antitumor activity of antifolate drugs. Clin Cancer Res 10(3):1080–89.

    Article  PubMed  CAS  Google Scholar 

  • Toffoli G, Cernigoi C, et al. (1997). Overexpression of folate binding protein in ovarian cancers. Int J Cancer 74(2):193–98.

    Article  PubMed  CAS  Google Scholar 

  • Toffoli G, Russo A, et al. (1998). Expression of folate binding protein as a prognostic factor for response to platinum-containing chemotherapy and survival in human ovarian cancer. Int J Cancer 79(2):121–26.

    Article  PubMed  CAS  Google Scholar 

  • Tran T, Shatnawi A, et al. (2005). Enhancement of folate receptor alpha expression in tumor cells through the glucocorticoid receptor: a promising means to improved tumor detection and targeting. Cancer Res 65(10):4431–41.

    Article  PubMed  CAS  Google Scholar 

  • Turk MJ, Breur GJ, et al. (2002). Folate-targeted imaging of activated macrophages in rats with adjuvant-induced arthritis. Arthritis Rheum 46(7):1947–55.

    Article  PubMed  Google Scholar 

  • van der Heijden JW, Oerlemans R, et al. (2009). Folate receptor beta as a potential delivery route for novel folate antagonists to macrophages in the synovial tissue of rheumatoid arthritis patients. Arthritis Rheum 60(1):12–21.

    Article  PubMed  CAS  Google Scholar 

  • van Zanten-Przybysz I, Molthoff CF, et al. (2000). Radioimmunotherapy with intravenously administered 131I-labeled chimeric monoclonal antibody MOv18 in patients with ovarian cancer. J Nucl Med 41(7):1168–76.

    PubMed  Google Scholar 

  • Walling J (2006). From methotrexate to pemetrexed and beyond. A review of the pharmacodynamic and clinical properties of antifolates. Invest New Drugs 24(1):37–77.

    Article  PubMed  Google Scholar 

  • Weitman SD, Lark RH, et al. (1992a). Distribution of the folate receptor GP38 in normal and malignant cell lines and tissues. Cancer Res 52(12):3396–401.

    PubMed  CAS  Google Scholar 

  • Weitman SD, Weinberg AG, et al. (1992b). Cellular localization of the folate receptor: potential role in drug toxicity and folate homeostasis. Cancer Res 52(23):6708–11.

    PubMed  CAS  Google Scholar 

  • Westerhof GR, Schornagel JH, et al. (1995). Carrier- and receptor-mediated transport of folate antagonists targeting folate-dependent enzymes: correlates of molecular-structure and biological activity. Mol Pharmacol 48(3):459–71.

    PubMed  CAS  Google Scholar 

  • Wollack JB, Makori B, et al. (2008). Characterization of folate uptake by choroid plexus epithelial cells in a rat primary culture model. J Neurochem 104(6):1494–503.

    Article  PubMed  CAS  Google Scholar 

  • Xia W, Hilgenbrink AR, et al. (2009). A functional folate receptor is induced during macrophage activation and can be used to target drugs to activated macrophages. Blood 113(2):438–46.

    Article  PubMed  CAS  Google Scholar 

  • Yasuda S, Hasui S, et al. (2008). Placental folate transport during pregnancy. Biosci Biotechnol Biochem 72(9):2277–84.

    Article  PubMed  CAS  Google Scholar 

  • Yuan Y, Nymoen DA, et al. (2009). Expression of the folate receptor genes FOLR1 and FOLR3 differentiates ovarian carcinoma from breast carcinoma and malignant mesothelioma in serous effusions. Hum Pathol 40(10):1453–60.

    Article  PubMed  CAS  Google Scholar 

  • Zhao X, Li H, et al. (2008). Targeted drug delivery via folate receptors. Expert Opin Drug Deliv 5(3):309–19.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ann L. Jackman .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Ng, C.H., Jackman, A.L. (2011). Potential for α-Folate Receptor-Targeted Treatment for Ovarian Cancer. In: Kaye, S., Brown, R., Gabra, H., Gore, M. (eds) Emerging Therapeutic Targets in Ovarian Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7216-3_12

Download citation

Publish with us

Policies and ethics