TY - JOUR
T1 - Receptor-Targeted Fluorescence-Guided Surgery With Low Molecular Weight Agents
AU - Hernandez Vargas, Servando
AU - Lin, Christie
AU - Tran Cao, Hop S.
AU - Ikoma, Naruhiko
AU - AghaAmiri, Solmaz
AU - Ghosh, Sukhen C.
AU - Uselmann, Adam J.
AU - Azhdarinia, Ali
N1 - Funding Information:
This work was supported by the Cancer Prevention and Research Institute of Texas (RP180812), John S. Dunn Research Scholar Fund, Welch Foundation Endowment, and National Cancer Institute of the National Institutes of Health (R44CA206754, OnLume Inc.). The authors thank Lea Stitzlein for assistance with figure preparation.
Publisher Copyright:
© Copyright © 2021 Hernandez Vargas, Lin, Tran Cao, Ikoma, AghaAmiri, Ghosh, Uselmann and Azhdarinia.
PY - 2021/6/30
Y1 - 2021/6/30
N2 - Cancer surgery remains the primary treatment option for most solid tumors and can be curative if all malignant cells are removed. Surgeons have historically relied on visual and tactile cues to maximize tumor resection, but clinical data suggest that relapse occurs partially due to incomplete cancer removal. As a result, the introduction of technologies that enhance the ability to visualize tumors in the operating room represents a pressing need. Such technologies have the potential to revolutionize the surgical standard-of-care by enabling real-time detection of surgical margins, subclinical residual disease, lymph node metastases and synchronous/metachronous tumors. Fluorescence-guided surgery (FGS) in the near-infrared (NIRF) spectrum has shown tremendous promise as an intraoperative imaging modality. An increasing number of clinical studies have demonstrated that tumor-selective FGS agents can improve the predictive value of fluorescence over non-targeted dyes. Whereas NIRF-labeled macromolecules (i.e., antibodies) spearheaded the widespread clinical translation of tumor-selective FGS drugs, peptides and small-molecules are emerging as valuable alternatives. Here, we first review the state-of-the-art of promising low molecular weight agents that are in clinical development for FGS; we then discuss the significance, application and constraints of emerging tumor-selective FGS technologies.
AB - Cancer surgery remains the primary treatment option for most solid tumors and can be curative if all malignant cells are removed. Surgeons have historically relied on visual and tactile cues to maximize tumor resection, but clinical data suggest that relapse occurs partially due to incomplete cancer removal. As a result, the introduction of technologies that enhance the ability to visualize tumors in the operating room represents a pressing need. Such technologies have the potential to revolutionize the surgical standard-of-care by enabling real-time detection of surgical margins, subclinical residual disease, lymph node metastases and synchronous/metachronous tumors. Fluorescence-guided surgery (FGS) in the near-infrared (NIRF) spectrum has shown tremendous promise as an intraoperative imaging modality. An increasing number of clinical studies have demonstrated that tumor-selective FGS agents can improve the predictive value of fluorescence over non-targeted dyes. Whereas NIRF-labeled macromolecules (i.e., antibodies) spearheaded the widespread clinical translation of tumor-selective FGS drugs, peptides and small-molecules are emerging as valuable alternatives. Here, we first review the state-of-the-art of promising low molecular weight agents that are in clinical development for FGS; we then discuss the significance, application and constraints of emerging tumor-selective FGS technologies.
KW - cancer-targeted agents
KW - contrast agents
KW - fluorescence-guided surgery
KW - low molecular weight agents
KW - receptor targeted imaging
KW - surgical oncology
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U2 - 10.3389/fonc.2021.674083
DO - 10.3389/fonc.2021.674083
M3 - Review article
C2 - 34277418
AN - SCOPUS:85110331816
SN - 2234-943X
VL - 11
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 674083
ER -