Mapping Antibody-Drug Conjugate Targets in High-Grade Serous Ovarian Cancer
By: Julia Cipriano, MS
Posted: Thursday, September 24, 2026
A retrospective analysis, published in the journal Gynecologic Oncology, characterized actionable antibody-drug conjugate targets in high-grade serous ovarian cancer. Ping-Li Sun, MD, PhD, of The Second Hospital of Jilin University, China, and colleagues found distinct expression patterns and clinicopathologic associations across the evaluated targets, with homologous recombination deficiency status and TROP2 emerging as independent prognostic factors for progression-free survival.
“Although FRα [folate receptor alpha] and HER2 do not demonstrate independent prognostic significance, they remain promising candidates for targeted therapy,” the investigators wrote.
The investigators focused on 193 patients with primary high-grade serous ovarian cancer. Expression of FRα, TROP2, and HER2 was evaluated by immunohistochemistry. Tumors were considered homologous recombination deficiency (HRD)-positive if they harbored pathogenic BRCA1/2 mutations and/or had a Genomic Scar Score of at least 45.
High FRα and TROP2 expression was observed in 51.8% and 24.9% of cases, respectively, whereas ultra-low HER2 expression was observed in 25.4%. Approximately two-thirds of the cohort (66.3%) had HRD-positive tumors. High expression of TROP2 was found to be significantly associated with advanced FIGO stage (P = .027), and overrepresentation of HER2 expression was seen among BRCA-mutated tumors (P = .020). Co-expression of all three markers was uncommon, according to the investigators, occurring in 7.8% of cases. Based on multivariable Cox regression analysis, HRD positivity was independently associated with favorable prognosis, whereas high TROP2 expression was independently associated with adverse prognosis.
“Collectively, these findings highlight the biologic heterogeneity of antibody-drug conjugate target expression in high-grade serous ovarian cancer and support the continued development of biomarker-informed strategies for the clinical application of antibody-drug conjugate–based therapies,” the investigators concluded. “Future studies integrating [HRD] status with antibody-drug conjugate target expression may further refine patient selection for targeted treatment.”
Disclosure: The study authors reported no conflicts of interest.
