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Monoclonal Antibodies for Targeted Fluorescence-Guided Surgery: A Review of Applicability across Multiple Solid
Stefano Giuliani1,2,3, Irene Paraboschi4, Angus McNair5,6
1Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London W1W 7TY, UK.
Abstract:
This study aims to review the status of the clinical use of monoclonal antibodies (mAbs) that have completed or are in ongoing clinical trials for targeted fluorescence-guided surgery (T-FGS) for the intraoperative identification of the tumor margins of extra-hematological solid tumors. For each of them, the targeted antigen, the mAb generic/commercial name and format, and clinical indications are presented, together with utility, doses, and the timing of administration. Based on the current scientific evidence in humans, the top three mAbs that could be prepared in a GMP-compliant bank ready to be delivered for surgical purposes are proposed to speed up the translation to the operating room and produce a few readily available "off-the-shelf" injectable fluorescent probes for safer and more effective solid tumor resection.
Insights
This review examines monoclonal antibodies (mAbs) for targeted fluorescence-guided surgery (T-FGS) in solid tumors. It identifies top mAbs for "off-the-shelf" use, aiming for safer and more effective tumor resection.
Area of Science:
- Oncology
- Surgical Innovation
- Molecular Imaging
Background:
- Monoclonal antibodies (mAbs) are increasingly investigated for targeted therapies.
- Accurate intraoperative identification of tumor margins remains a challenge in solid tumor surgery.
- Targeted fluorescence-guided surgery (T-FGS) offers a promising approach to improve surgical precision.
Purpose of the Study:
- To review the clinical status of mAbs used in T-FGS for extra-hematological solid tumors.
- To identify and present key characteristics of relevant mAbs, including targets, indications, and administration details.
- To propose a selection of mAbs suitable for GMP-compliant banking to facilitate clinical translation.
Main Methods:
- Systematic review of clinical trials involving mAbs for T-FGS.
- Analysis of data on targeted antigens, mAb names, clinical indications, utility, doses, and administration timing.
- Evaluation of scientific evidence for clinical readiness and potential for "off-the-shelf" availability.
Main Results:
- Several mAbs are in clinical trials for T-FGS in solid tumors.
- Detailed information on targeted antigens, mAb formats, and clinical applications is presented.
- Three top mAbs are identified as candidates for GMP-compliant preparation for surgical use.
Conclusions:
- Monoclonal antibodies show significant potential for enhancing intraoperative tumor margin identification in solid tumors.
- Establishing a bank of readily available, GMP-compliant fluorescent probes will accelerate the adoption of T-FGS.
- This approach promises safer and more effective surgical resection of extra-hematological solid tumors.
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