Background: Folate receptor alpha (FRα), commonly expressed in epithelial ovarian cancers, is a clinically actionable biomarker following approval of the antibody–drug conjugate mirvetuximab soravtansine (MIRV). Pivotal trials showed that high FRα expression predicts MIRV benefit, creating the need for standardized testing to ensure timely, equitable access. Methods: To address the need for guidance on FRα testing, the Society of Gynecologic Oncology of Canada convened a multidisciplinary Expert Panel to review the evidence and integrate Canadian clinical, pathology, laboratory, and patient perspectives. Consensus recommendations were developed through structured evidence review, expert discussion, iterative revision, and patient partner input. Results: The panel issued recommendations on the clinical role and timing of FRα testing, tissue requirements, assay selection and validation, interpretation and reporting standards, laboratory quality assurance, reimbursement, and equitable access. It is recommended that FRα testing be available to all patients with epithelial ovarian cancer, with results available no later than platinum-resistant disease, using a validated assay, preferably the Ventana FOLR1 RxDx assay or an appropriately validated laboratory-developed test. Standardized synoptic reporting, participation in external quality assurance programs, and clear patient communication were deemed essential. Conclusions: These recommendations aim to promote integrated, equitable, standardized FRα testing across Canada and support timely identification of patients eligible for FRα-directed therapy, clinical trial enrollment, and future biomarker-driven treatment strategies.
Ma et al. (Mon,) studied this question.