Evaluation of fluorescence-guided surgery agents in a murine model of soft tissue fibrosarcoma

Area of Science:

• Oncology
• Surgical Oncology
• Medical Imaging

Background:

• Soft tissue sarcomas (STS) are mesenchymal malignancies requiring surgical resection.
• Achieving negative margins is crucial for optimal oncologic outcomes.
• Fluorescence-guided surgery (FGS) offers potential for improved margin delineation and reduced morbidity.

Purpose of the Study:

• To evaluate the tumor-targeting specificity and utility of novel fluorescence-imaging agents for STS.
• To determine the efficacy of different probes in providing disease-specific contrast for intraoperative margin assessment.
• To assess the potential of FGS to improve local tumor control and minimize resection-associated morbidity.

Main Methods:

• Mice bearing HT1080 fibrosarcoma tumors were administered one of five fluorescence probes: cetuximab-IRDye800CW, DC101-IRDye800CW, IgG-IRDye800CW, Prosense750EX, or IntegriSense750.
• Tumors were imaged daily using open- and closed-field fluorescence imaging systems to evaluate tumor-to-background ratios (TBR).
• Probe sensitivity and microscopic tumor affinity were assessed on peak TBR days.

Main Results:

• Cetuximab-IRDye800CW achieved a significantly greater peak TBR (16.8) in closed-field imaging compared to other agents.
• All agents detected as little as 1.0 mg of residual tumor, with cetuximab-IRDye800CW providing the highest contrast (2.5).
• Microscopic analysis confirmed strong tumor affinity for cetuximab-IRDye800CW, with fluorescence intensity significantly higher within 0.2 mm of the tumor border.

Conclusions:

• Cetuximab-IRDye800CW demonstrated superior tumor-targeting specificity and contrast among the evaluated agents.
• FGS utilizing cetuximab-IRDye800CW holds promise for enhancing disease detection during surgery.
• This approach has the potential to improve post-resection outcomes by reducing morbidity and mortality.