Abstract
Surgery is often the first treatment option for patients with cancer. Patient survival essentially depends on the completeness of tumor resection. This is a major challenge, particularly in cases of peritoneal carcinomatosis, where tumors are widely disseminated in the large peritoneal cavity. Any development to help surgeons visualize these residual cells would improve the completeness of the surgery. For non-disseminated tumors, imaging could be used to ensure that the tumor margins and the draining lymph nodes are free of tumor deposits.Near-infrared fluorescence imaging has been shown to be one of the most convenient imaging modalities. Our aim was to evaluate the efficacy of a near-infrared fluorescent probe targeting the αvβ3 integrins (Angiostamp™) for intraoperative detection of tumors using the Fluobeam® device.We determined whether different human tumor nodules from various origins could be detected in xenograft mouse models using both cancer cell lines and patient-derived tumor cells. We found that xenografts could be imaged by fluorescent staining irrespective of their integrin expression levels. This suggests imaging of the associated angiogenesis of the tumor and a broader potential utilization of Angiostamp™. We therefore performed a veterinary clinical trial in cats and dogs with local tumors or with spontaneous disseminated peritoneal carcinomatosis. Our results demonstrate that the probe can specifically visualize both breast and ovarian nodules, and suggest that Angiostamp™ is a powerful fluorescent contrast agent that could be used in both human and veterinary clinical trials for intraoperative detection of tumors.
Highlights
In oncology, if tumor resection is feasible, surgery is often the first therapeutic option
For non-disseminated tumors, imaging could be used to ensure that the tumor margins and the draining lymph nodes are free of tumor deposits
For peritoneal carcinomatosis, which can occur in cases of colorectal or ovarian cancer or rare peritoneal disease, several retrospective studies demonstrate that patient survival essentially depends on the completeness of macroscopic www.impactjournals.com/oncotarget tumor resection and on adjuvant chemotherapy [1, 2]
Summary
If tumor resection is feasible, surgery is often the first therapeutic option. For peritoneal carcinomatosis, which can occur in cases of colorectal or ovarian cancer or rare peritoneal disease, several retrospective studies demonstrate that patient survival essentially depends on the completeness of macroscopic www.impactjournals.com/oncotarget tumor resection and on adjuvant chemotherapy [1, 2]. Optimizing the extensiveness of cytoreductive surgery without collateral damage is still a major challenge [6]. For other cancers, such as breast cancers, sarcomas, and gliomas, improved imaging could help detect small tumor deposits surrounding the main tumor. Detecting these using real-time imaging could help ensure the completeness of tumor removal with adequate tumor margins. Patients who have had complete tumor resection derive the most benefit from chemotherapy treatment compared with those who have had incomplete resection, for locally invasive tumors such as gliomas [7]
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