Folate receptor alpha (FRα) is a cell surface GPI-anchored protein overexpressed in several solid tumors with highest prevalence in ovarian cancer and lung adenocarcinoma but restricted expression in normal tissues. An antibody drug conjugate (ADC) with a microtubule inhibitor (MTI) payload recently received accelerated approval from the FDA for FRα-expressing platinum-resistant ovarian cancer. Thus, folate receptor alpha is a clinically validated target with commercial potential as evidenced by sales of more than US$ 500 mln in its second full year of commercialization after first approval in 2022. Furthermore, the FRα-targeted ADC was the main reason for an equity value of US$ 10 bln when the originator company Immunogen was acquired by Abbvie.
Folate receptor alpha holds great promise as a target for next generation improved drug candidates based on drug modalities known to enhance effector function and/or to broaden the therapeutic window. Among FRα-targeted drug modalities in use for next generation therapy candidates are ADCs with novel targeting moieties and linker/payload technologies as well as novel small molecule drug conjugates. Furthermore, next generation cell therapy modalities and radiopharmaceuticals are advancing in the pipeline. And T-cell or NK cell engaging bispecific antibodies are further drug modalities applied to folate receptor alpha therapies.

