MP40-05 c-MET RECEPTOR-TARGETED FLUORESCENCE ON THE ROAD TO IMAGE-GUIDED SURGERY IN PENILE SQUAMOUS CELL CARCINOMA PATIENTS

Abstract

You have accessJournal of UrologyPenile & Testicular Cancer I (MP40)1 Sep 2021MP40-05 c-MET RECEPTOR-TARGETED FLUORESCENCE ON THE ROAD TO IMAGE-GUIDED SURGERY IN PENILE SQUAMOUS CELL CARCINOMA PATIENTS Hielke de Vries, Elise Bekers, Matthias van Oosterom, Baris Karakullukcu, Henk van der Poel, Fijs van Leeuwen, Tessa Buckle, and Oscar Brouwer Hielke de VriesHielke de Vries More articles by this author , Elise BekersElise Bekers More articles by this author , Matthias van OosteromMatthias van Oosterom More articles by this author , Baris KarakullukcuBaris Karakullukcu More articles by this author , Henk van der PoelHenk van der Poel More articles by this author , Fijs van LeeuwenFijs van Leeuwen More articles by this author , Tessa BuckleTessa Buckle More articles by this author , and Oscar BrouwerOscar Brouwer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002055.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In penile squamous cell carcinoma (pSCC), primary surgery aims to obtain oncologically safe margins while minimizing mutilation. Surgical guidance provided by receptor-specific tracers could potentially improve margin detection and reduce unnecessary excision of healthy tissue. Here, we present the first results of a prospective feasibility study for real-time intraoperative visualization of pSCC using a fluorescent c-MET receptor targeting tracer (EMI-137). METHODS: EMI-137 tracer performance was initially assessed ex vivo (N=10) via incubation of freshly excised pSCC in a solution containing EMI-137 (500 nM). The in vivo potential of c-MET targeting and intraoperative tumour visualization was assessed after intravenous administration of EMI-137 in five pSCC patients scheduled for surgical resection using a Cy5 fluorescence camera. Fluorescence imaging results were related to standard pathological tumour evaluation and c-MET immunohistochemistry. Three of the five in vivo patients also underwent a sentinel node resection after local administration of the hybrid tracer ICG-99mTc-nanocolloid, which could be imaged using a near-infrared fluorescence camera. RESULTS: No tracer-related adverse events were encountered. Both ex vivo and in vivo, EMI-137 enabled c-MET based tumour visualization in all patients. Histopathological analyses showed that all pSCC's expressed c-MET, with expression levels of ≥70% in 14/15 patients. Moreover, the highest c-MET expression levels were seen on the outside rim of the tumours, and a visual correlation was found between c-MET expression and fluorescence signal intensity. No complications were encountered when combining primary tumour targeting with lymphatic mapping. As such, simultaneous use of Cy5 and ICG in the same patient proved to be feasible. CONCLUSIONS: Fluorescence imaging of c-MET receptor-expressing pSCC tumours after intravenous injection of EMI-137 was shown to be feasible and can be combined with fluorescence-based lymphatic mapping. This combination is unique and paves the way towards further development of this surgical guidance approach. Source of Funding: This research was financially supported by a Netherlands Organization for Scientific Research TTW-VICI grant (Grant No. TTW 16141). EMI-137 was provided by Edinburgh Molecular Imaging (EMI), KARL STORZ provided the Cy5 fluorescence camera, and the FIS-00 near-infrared fluorescence camera was made available by Hamamatsu photonics © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e716-e716 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hielke de Vries More articles by this author Elise Bekers More articles by this author Matthias van Oosterom More articles by this author Baris Karakullukcu More articles by this author Henk van der Poel More articles by this author Fijs van Leeuwen More articles by this author Tessa Buckle More articles by this author Oscar Brouwer More articles by this author Expand All Advertisement Loading ...