EXPRESSION OF FOLATE BINDING-PROTEIN AS A PROGNOSTIC FACTOR FOR RESPONSE TO PLATINUM-CONTAINING CHEMOTHERAPY AND SURVIVAL IN HUMAN OVARIAN-CANCER

Overexpression of the folate binding protein (FBP) is a common feature in epithelial ovarian cancer, but its prognostic significance is not clearly understood, We investigated whether FBP in epithelial ovarian cancer specimens is a predictor of response to chemotherapy and surviv al, Behr/een 1990 and 1995, 99 patients with epithelial ovarian cancer underwent primary surgery and were treated with chemotherapeutic regi mens including platinum derivatives. First-line chemotherapy was perfo rmed in 58 patients with residual disease and in 41 patients without r esidual disease after primary laparotomy, FBP expression level was det ermined in frozen specimens by cyto-fluorimetric assay using the MOv 1 8 monoclonal antibody (MAb), Association of FBP fluorescence index (FI ) with clinical characteristics, response to chemotherapy, and surviva l was studied by univariate and multivariate analysis. In the 58 patie nts with residual disease after primary surgery, failure to respond to chemotherapy (complete or partial remission) was about 15-fold higher (95% confidence interval, 2.96-77.43) when tumors had FBF FI above th e median value (FBF FI = 3.25), FBP FI was not a predictor of survival in the entire series of tumors (99 patients). However, in the subgrou p of 58 patients with residual disease after primary surgery, survival analysis confirmed the disadvantage observed with respect to response to chemotherapy in patients expressing FBP FI above the median value (hazard ratio 2.0 l;95% confidence interval 0.95-4.24). In conclusion, higher levels of FBP expression might be a predictor of chemotherapy response failure in ovarian cancer. In patients with residual disease after primary surgery, FBF FI could represent a valuable prognostic ma rker for survival. (C) 1998 Wiley-Liss, Inc.