Receptor-Targeted Fluorescence-Guided Surgery With Low Molecular Weight Agents

Area of Science:

• Oncology
• Surgical Innovation
• Medical Imaging

Background:

• Cancer surgery is the primary curative treatment for solid tumors, but incomplete resection leads to relapse.
• Current visualization methods rely on visual and tactile cues, which are insufficient for detecting all malignant cells.
• Advanced imaging technologies are needed to improve intraoperative tumor detection and surgical outcomes.

Purpose of the Study:

• To review the current state of low molecular weight agents for fluorescence-guided surgery (FGS).
• To discuss the significance, applications, and limitations of emerging tumor-selective FGS technologies.
• To highlight the potential of FGS to revolutionize cancer surgery.

Main Methods:

• Review of clinical studies on near-infrared fluorescence-guided surgery (NIRF-FGS) agents.
• Analysis of emerging low molecular weight agents (peptides, small molecules) in clinical development.
• Discussion of macromolecule-based (antibody) FGS agents and their clinical translation.

Main Results:

• Tumor-selective FGS agents significantly improve fluorescence detection compared to non-targeted dyes.
• Low molecular weight agents are emerging as viable alternatives to antibodies for FGS.
• NIRF-FGS shows promise for real-time detection of surgical margins, residual disease, and metastases.

Conclusions:

• FGS, particularly with tumor-selective agents, has the potential to significantly improve cancer resection accuracy.
• Low molecular weight agents offer a promising avenue for advancing FGS technologies.
• Further development and clinical application of FGS are crucial for enhancing surgical standards in oncology.