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Review of clinical trials in intraoperative molecular imaging during cancer surgery
John Y K Lee1, Steve S Cho1, Walter Stummer2
1University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States.
Abstract:
Most solid cancers are treated by surgical resections to reduce the burden of disease. Surgeons often face the challenge of detecting small areas of residual neoplasm after resection or finding small primary tumors for the initial resection. Intraoperative molecular imaging (IMI) is an emerging technology with the potential to dramatically improve cancer surgery operations by allowing surgeons to better visualize areas of neoplasm using fluorescence imaging. Over the last two years, two molecular optical contrast agents received U.S. Food and Drug Administration approval, and several more drugs are now on the horizon. Thus a conference was organized at the University of Pennsylvania to bring together oncologic surgeons from different specialties to discuss the current clinical status of IMI trials with a specific focus on phase 2 and phase 3 studies. In addition, phase 1 and experimental trials were also discussed briefly, to highlight other novel techniques. Our review summarizes the discussions from the conference and delves into the types of cancers discussed, different contrast agents in human trials, and the clinical value being studied.
Insights
Intraoperative molecular imaging (IMI) enhances cancer surgery by enabling surgeons to visualize residual or primary tumors using fluorescence imaging. This review summarizes recent advancements and clinical trials of IMI in oncology.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Imaging
Background:
- Solid cancer treatment often involves surgical resection.
- Detecting residual or primary tumors during surgery remains a challenge.
- Intraoperative molecular imaging (IMI) offers improved visualization through fluorescence imaging.
Purpose of the Study:
- To review the current clinical status of IMI trials.
- To discuss the application of IMI in various cancer types.
- To evaluate the clinical value of novel imaging agents and techniques.
Main Methods:
- Summarizing discussions from a conference focused on IMI trials.
- Reviewing Phase 1, 2, and 3 clinical trials of IMI.
- Analyzing different molecular optical contrast agents in human trials.
Main Results:
- Two molecular optical contrast agents have received FDA approval.
- Several novel contrast agents are nearing clinical availability.
- Ongoing trials are investigating the clinical utility of IMI in cancer surgery.
Conclusions:
- IMI is a rapidly advancing technology with the potential to significantly improve cancer surgery outcomes.
- Further research and clinical trials are essential to fully establish the value of IMI.
- The development of new contrast agents is expanding the possibilities for intraoperative tumor detection.
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