Nontoxic Tumor-Targeting Optical Agents for Intraoperative Breast Tumor Imaging

Area of Science:

• Oncology
• Surgical Oncology
• Medical Imaging

Background:

• Accurate identification of tumor margins in breast-conserving surgery (BCS) is critical but challenging due to subtle tissue differences.
• Achieving negative margins is essential to minimize local recurrence and improve patient outcomes.

Purpose of the Study:

• To develop and evaluate a novel fluorescent imaging agent, ICG-p28, for intraoperative guidance in BCS.
• To assess the pharmacokinetics, biodistribution, and preclinical toxicity of ICG-p28.
• To determine the efficacy of ICG-p28 in reducing tumor recurrence in a relevant animal model.

Main Methods:

• Pharmacokinetic (PK) and biodistribution studies were performed to understand ICG-p28's behavior in vivo.
• Preclinical toxicity was assessed using various breast cancer and normal cell lines.
• ICG-p28 was evaluated in transgenic mice with spontaneous invasive mammary tumors for intraoperative imaging and recurrence assessment.

Main Results:

• ICG-p28 demonstrated rapid tissue uptake and specific localization at tumor sites.
• No dose-related effects or significant toxicity were observed in tested cell lines.
• Intraoperative imaging with ICG-p28 in mice led to a significant reduction in tumor recurrence rates.

Conclusions:

• ICG-p28 is a safe, nontoxic, and cost-effective fluorescent imaging agent for intraoperative margin identification in BCS.
• This approach aids surgeons in achieving negative margins, potentially improving patient outcomes by reducing recurrence.
• ICG-p28 offers a promising new tool for enhancing surgical precision in breast cancer treatment.