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Solidoro R, Centonze A, Miciaccia M, Baldelli OM, Armenise D, Ferorelli S, Perrone MG, Scilimati A. Fluorescent imaging probes for in vivo ovarian cancer targeted detection and surgery. Med Res Rev 2024; 44:1800-1866. [PMID: 38367227 DOI: 10.1002/med.22027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/05/2023] [Accepted: 01/25/2024] [Indexed: 02/19/2024]
Abstract
Ovarian cancer is the most lethal gynecological cancer, with a survival rate of approximately 40% at five years from the diagno. The first-line treatment consists of cytoreductive surgery combined with chemotherapy (platinum- and taxane-based drugs). To date, the main prognostic factor is related to the complete surgical resection of tumor lesions, including occult micrometastases. The presence of minimal residual diseases not detected by visual inspection and palpation during surgery significantly increases the risk of disease relapse. Intraoperative fluorescence imaging systems have the potential to improve surgical outcomes. Fluorescent tracers administered to the patient may support surgeons for better real-time visualization of tumor lesions during cytoreductive procedures. In the last decade, consistent with the discovery of an increasing number of ovarian cancer-specific targets, a wide range of fluorescent agents were identified to be employed for intraoperatively detecting ovarian cancer. Here, we present a collection of fluorescent probes designed and developed for fluorescence-guided ovarian cancer surgery. Original articles published between 2011 and November 2022 focusing on fluorescent probes, currently under preclinical and clinical investigation, were searched in PubMed. The keywords used were targeted detection, ovarian cancer, fluorescent probe, near-infrared fluorescence, fluorescence-guided surgery, and intraoperative imaging. All identified papers were English-language full-text papers, and probes were classified based on the location of the biological target: intracellular, membrane, and extracellular.
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Affiliation(s)
- Roberta Solidoro
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari, Bari, Italy
| | - Antonella Centonze
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari, Bari, Italy
| | - Morena Miciaccia
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari, Bari, Italy
| | - Olga Maria Baldelli
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari, Bari, Italy
| | - Domenico Armenise
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari, Bari, Italy
| | - Savina Ferorelli
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari, Bari, Italy
| | | | - Antonio Scilimati
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari, Bari, Italy
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De Soricellis G, Fagnani F, Colombo A, Dragonetti C, Roberto D. Exploring the potential of N^C^N cyclometalated Pt(II) complexes bearing 1,3-di(2-pyridyl)benzene derivatives for imaging and photodynamic therapy. Inorganica Chim Acta 2022. [DOI: 10.1016/j.ica.2022.121082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Josserand V, Bernard C, Michy T, Guidetti M, Vollaire J, Coll JL, Hurbin A. Tumor-Specific Imaging with Angiostamp800 or Bevacizumab-IRDye 800CW Improves Fluorescence-Guided Surgery over Indocyanine Green in Peritoneal Carcinomatosis. Biomedicines 2022; 10:biomedicines10051059. [PMID: 35625796 PMCID: PMC9138305 DOI: 10.3390/biomedicines10051059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022] Open
Abstract
Complete surgical removal of lesions improves survival of peritoneal carcinomatosis and can be enhanced by intraoperative near-infrared fluorescence imaging. Indocyanine green (ICG) is the only near-infrared fluorescent dye approved for clinical use, but it lacks specificity for tumor cells, highlighting the need for tumor-selective targeting agents. We compared the tumor-specific near-infrared fluorescent probes Bevacizumab-IRDye 800CW and Angiostamp800, which target tumor angiogenesis and cancer cells, to ICG for fluorescence-guided surgery in peritoneal carcinomatosis of ovarian origin. The probes were administered to mice with orthotopic peritoneal carcinomatosis prior to conventional and fluorescence-guided surgery. The influence of neoadjuvant chemotherapy was also assessed. Conventional surgery removed 88.0 ± 1.2% of the total tumor load in mice. Fluorescence-guided surgery allowed the resection of additional nodules, enhancing the total tumor burden resection by 9.8 ± 0.7%, 8.5 ± 0.8%, and 3.9 ± 1.2% with Angiostamp800, Bevacizumab-IRDye 800CW and ICG, respectively. Interestingly, among the resected nodules, 15% were false-positive with ICG, compared to only 1.4% with Angiostamp800 and 3.5% with Bevacizumab-IRDye 800CW. Furthermore, conventional surgery removed only 69.0 ± 3.9% of the total tumor burden after neoadjuvant chemotherapy. Fluorescence-guided surgery with Angiostamp800 and Bevacizumab-IRDye 800CW increased the total tumor burden resection to 88.7 ± 4.3%, whereas ICG did not improve surgery at all. Bevacizumab-IRDye 800CW and Angiostamp800 better detect ovarian tumors and metastases than the clinically used fluorescent tracer ICG, and can help surgeons completely remove tumors, especially after surgery neoadjuvant chemotherapy.
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Affiliation(s)
- Véronique Josserand
- Institute for Advanced Biosciences, Institut National de la Santé et de la Recherche Médicale INSERM U1209, Centre National de la Recherche Scientifique CNRS UMR5309, Université Grenoble Alpes, F-38000 Grenoble, France; (V.J.); (C.B.); (T.M.); (M.G.); (J.V.); (J.-L.C.)
| | - Claire Bernard
- Institute for Advanced Biosciences, Institut National de la Santé et de la Recherche Médicale INSERM U1209, Centre National de la Recherche Scientifique CNRS UMR5309, Université Grenoble Alpes, F-38000 Grenoble, France; (V.J.); (C.B.); (T.M.); (M.G.); (J.V.); (J.-L.C.)
- Centre Hospitalier Universitaire Grenoble Alpes, Université Grenoble Alpes, F-38000 Grenoble, France
| | - Thierry Michy
- Institute for Advanced Biosciences, Institut National de la Santé et de la Recherche Médicale INSERM U1209, Centre National de la Recherche Scientifique CNRS UMR5309, Université Grenoble Alpes, F-38000 Grenoble, France; (V.J.); (C.B.); (T.M.); (M.G.); (J.V.); (J.-L.C.)
- Centre Hospitalier Universitaire Grenoble Alpes, Université Grenoble Alpes, F-38000 Grenoble, France
| | - Mélanie Guidetti
- Institute for Advanced Biosciences, Institut National de la Santé et de la Recherche Médicale INSERM U1209, Centre National de la Recherche Scientifique CNRS UMR5309, Université Grenoble Alpes, F-38000 Grenoble, France; (V.J.); (C.B.); (T.M.); (M.G.); (J.V.); (J.-L.C.)
| | - Julien Vollaire
- Institute for Advanced Biosciences, Institut National de la Santé et de la Recherche Médicale INSERM U1209, Centre National de la Recherche Scientifique CNRS UMR5309, Université Grenoble Alpes, F-38000 Grenoble, France; (V.J.); (C.B.); (T.M.); (M.G.); (J.V.); (J.-L.C.)
| | - Jean-Luc Coll
- Institute for Advanced Biosciences, Institut National de la Santé et de la Recherche Médicale INSERM U1209, Centre National de la Recherche Scientifique CNRS UMR5309, Université Grenoble Alpes, F-38000 Grenoble, France; (V.J.); (C.B.); (T.M.); (M.G.); (J.V.); (J.-L.C.)
| | - Amandine Hurbin
- Institute for Advanced Biosciences, Institut National de la Santé et de la Recherche Médicale INSERM U1209, Centre National de la Recherche Scientifique CNRS UMR5309, Université Grenoble Alpes, F-38000 Grenoble, France; (V.J.); (C.B.); (T.M.); (M.G.); (J.V.); (J.-L.C.)
- Correspondence:
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de Jong JM, Hoogendam JP, Braat AJAT, Zweemer RP, Gerestein CG. The feasibility of folate receptor alpha- and HER2-targeted intraoperative fluorescence-guided cytoreductive surgery in women with epithelial ovarian cancer: A systematic review. Gynecol Oncol 2021; 162:517-525. [PMID: 34053747 DOI: 10.1016/j.ygyno.2021.05.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/20/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Epithelial ovarian cancer (EOC) is often diagnosed late, with a 5-year relative survival of 30.2% for patients with metastatic disease. Residual disease following cytoreductive surgery is an important predictor for poor survival. EOC is characterized by diffuse peritoneal metastases and depositions of small size, challenging a complete resection. Targeted fluorescence imaging is a technique to enhance tumor visualization and can be performed intraoperatively. Folate receptor alpha (FRα) and human epidermal growth factor receptor 2 (HER2) are overexpressed in EOC in 80% and 20% of the cases, respectively, and have been previously studied as a target for intraoperative imaging. OBJECTIVE To systematically review the literature on the feasibility of FRα and HER2 targeted fluorescence-guided cytoreductive surgery (FGCS) in women with EOC. METHODS PubMed and Embase were searched for human and animal studies on FGCS targeting either HER2 or FRα in either women with EOC or animal models of EOC. Risk of bias and methodological quality were assessed with the SYRCLE and MINORS tool, respectively. RESULTS All animal studies targeting either FRα or HER2 were able to detect tumor deposits using intraoperative fluorescence imaging. One animal study targeting HER2 compared conventional cytoreductive surgery (CCS) to FGCS and concluded that FGCS, either without or following CCS, resulted in statistically significant less residual disease compared to CCS alone. Human studies on FGCS showed an increased detection rate of tumor deposits. True positives ranged between 75%-77% and false positives between 10%-25%. Lymph nodes were the main source of false positive results. Sensitivity was 85.9%, though only reported by one human study. CONCLUSION FGCS targeting either HER2 or FRα appears to be feasible in both EOC animal models and patients with EOC. FGCS is a promising technique, but further research is warranted to validate these results and particularly study the survival benefit.
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Affiliation(s)
- J M de Jong
- Department of Gynaecological Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J P Hoogendam
- Department of Gynaecological Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - A J A T Braat
- Department of Nuclear Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - R P Zweemer
- Department of Gynaecological Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - C G Gerestein
- Department of Gynaecological Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
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Lavaud J, Henry M, Gayet P, Fertin A, Vollaire J, Usson Y, Coll JL, Josserand V. Noninvasive monitoring of liver metastasis development via combined multispectral photoacoustic imaging and fluorescence diffuse optical tomography. Int J Biol Sci 2020; 16:1616-1628. [PMID: 32226306 PMCID: PMC7097915 DOI: 10.7150/ijbs.40896] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/18/2020] [Indexed: 12/16/2022] Open
Abstract
Rationale:In vivo molecular imaging in preclinical animal models is a tool of choice for understanding the pathophysiological mechanisms involved in cancer development and for conducting drug development research. Moreover, combining several imaging modalities can provide multifaceted, complementary and cross-validated information. Photoacoustic imaging (PAI) is a promising imaging modality that can reflect blood vasculature and tissue oxygenation as well as detect exogenous molecules, but one shortcoming of PAI is a lack of organic photoacoustic contrast agents capable of providing tumor contrast. Methods: In the present study, we designed an animal model of liver metastases from colon cancer and monitored metastasis development by in vivo bioluminescence and X-ray microcomputed tomography. Contrast-agent-free PAI was used to detect the respective amounts of oxy- and deoxyhemoglobin and, thus, liver tissue oxygenation. two contrast agents, Angiostamp800 and indocyanin green (ICG), respectively with and without tumor targeting specificity, were then evaluated for their dual fluorescence and photoacoustic detectability and were then used for combined PAI and fluorescence diffuse optical tomography (fDOT) at various disease development stages. Findings: Contrast-agent-free PAI reflected tumor angiogenesis and gradual hypoxia during metastasis development. Multispectral PAI enabled noninvasive real-time monitoring of ICG blood pharmacokinetics, which demonstrated tumor-related liver dysfunction. Both PAI and fluorescence ICG signals were clearly modified in metastasis-bearing livers but did not allow for differentiation between different disease stages. In contrast, there was a significant improvement achieved by using the tumor-specific marker Angiostamp800, which provided gradually increasing PAI and fDOT signals during metastasis development. Conclusion: We demonstrated for the first time the value of using Angiostamp800 as a bimodal tumor-targeting contrast agent for combined PAI and fluorescence imaging of liver metastasis progression in vivo.
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Affiliation(s)
- Jonathan Lavaud
- OPTIMAL, Small animal Imaging Platform, F-38000 Grenoble, France.,INSERM U1209, CNRS UMR5309, Univ. Grenoble Alpes, Institute for Advanced Biosciences, F-38000 Grenoble, France
| | - Maxime Henry
- OPTIMAL, Small animal Imaging Platform, F-38000 Grenoble, France.,INSERM U1209, CNRS UMR5309, Univ. Grenoble Alpes, Institute for Advanced Biosciences, F-38000 Grenoble, France
| | | | - Arnold Fertin
- CNRS UMR5525 ; TIMC-IMAG, Univ. Grenoble Alpes, F-38000 Grenoble, France
| | - Julien Vollaire
- OPTIMAL, Small animal Imaging Platform, F-38000 Grenoble, France.,INSERM U1209, CNRS UMR5309, Univ. Grenoble Alpes, Institute for Advanced Biosciences, F-38000 Grenoble, France
| | - Yves Usson
- CNRS UMR5525 ; TIMC-IMAG, Univ. Grenoble Alpes, F-38000 Grenoble, France
| | - Jean-Luc Coll
- OPTIMAL, Small animal Imaging Platform, F-38000 Grenoble, France.,INSERM U1209, CNRS UMR5309, Univ. Grenoble Alpes, Institute for Advanced Biosciences, F-38000 Grenoble, France
| | - Véronique Josserand
- OPTIMAL, Small animal Imaging Platform, F-38000 Grenoble, France.,INSERM U1209, CNRS UMR5309, Univ. Grenoble Alpes, Institute for Advanced Biosciences, F-38000 Grenoble, France
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Gurkan D, Ceren Akin A, Sahin H, Aytac Tohma Y, Sahin EA, Gunakan E, Iflazoglu N, Nihan Haberal A, Ayhan A. Oncologic outcomes in patients undergoing maximal or optimal cytoreductive surgery for Stage 3C serous ovarian, tubal or peritoneal carcinomas. J OBSTET GYNAECOL 2019; 40:551-557. [PMID: 31482736 DOI: 10.1080/01443615.2019.1634028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim of this study was to evaluate overall survival (OS) and disease-free survival (DFS) of patients with Stage 3C serous ovarian, tubal and peritoneal carcinomas. A retrospective analysis of 111 patients who underwent maximal or optimal cytoreductive surgery was performed. Patients were divided into three groups as ovarian cancer (n = 47), tubal cancer (n = 24) and peritoneal cancer (n = 40). Median follow-up was 30 months. There was no significant difference in DFS and OS among the groups. Complete cytoreduction was an independent prognostic factor for DFS in all groups (HR 2.3, 95% CI 1.14-4.93; p=.020). Positive peritoneal cytology (HR 2.2, 95% CI 1.02-4.78; p=.044), and retroperitoneal lymph node involvement (HR 2.3, 95% CI1.11-4.89; p=.025) were independent risk factors for decreased OS, and extended cytoreduction (HR 2.7, 95% CI 1.05-6.99; p=.039) were independent risk factors for increased OS. In conclusion, these malignancies should be considered a single entity during treatment.IMPACT STATEMENTWhat is already known on this subject? Epithelial ovarian cancer is the second most common gynaecological cancer in women worldwide. There are different histological types including ovarian, tubal and peritoneal carcinomas in which malignant cells form in the tissue covering the ovary or lining the fallopian tube of peritoneum. Recent data have supported the view that these malignancies should be considered a single entity and should be treated the same way.What the results of this study add? In the present study, we evaluated overall survival and disease-free survival of patients with Stage 3C ovarian, tubal and peritoneal cancer undergoing maximal or optimal cytoreductive surgery. We found similar oncologic outcomes in all patient groups. To the best of our knowledge, this is the first study to compare oncologic outcomes of these similar and often confused malignancies in the literature. We, therefore, believe that the present study provides additional information to the body of knowledge on this topic.What the implications are of these findings for clinical practice and/or further research? This study is important, as it indicates similar oncologic outcomes in patients undergoing maximal or optimal cytoreductive surgery for Stage 3C ovarian, tubal and peritoneal cancer. Based on these findings, clinicians should keep in mind that these malignancies should be considered a single clinical entity and be treated the same way. We believe that our study would pave the way for further studies regarding this subject.
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Affiliation(s)
- Damla Gurkan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Aylin Ceren Akin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Hanifi Sahin
- Department of Gynecologic Oncology, Malatya Education and Research Hospital, Malatya, Turkey
| | - Yusuf Aytac Tohma
- Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Eda Adeviye Sahin
- Department of Obstetrics and Gynecology, Malatya Education and Research Hospital, Malatya, Turkey
| | - Emre Gunakan
- Department of Obstetrics and Gynecology, Keçiören Education and Research Hospital, Ankara, Turkey
| | - Nidal Iflazoglu
- Department of Surgical Oncology, Malatya Education and Research Hospital, Malatya, Turkey
| | | | - Ali Ayhan
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Ankara, Turkey
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Long Y, Yao Y, Yao DS. Indocyanine green angiography for preserving the ureteral branch of the uterine artery during radical hysterectomy: Two case report. Medicine (Baltimore) 2018; 97:e12692. [PMID: 30290662 PMCID: PMC6200471 DOI: 10.1097/md.0000000000012692] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Conventional radical hysterectomy is frequently associated with postoperative ureteral ischemic necrosis, urinary fistula, stenosis, and kidney seeper. Some have suggested that preserving the ureteral branch during radical hysterectomy may reduce the incidence of ureteral complications. However, the feasibility of such preservation has not been explored using intraoperative imaging techniques. PATIENT CONCERNS Two cervical cancer patients aged 45 and 53 years were selected to undergo surgery in our hospital in October 2017. Both patients showed normal function of major organs and no special treatment was deemed necessary based on their subjective symptoms and preoperative examination. DIAGNOSES Both patients were diagnosed with cervical cancer in stage Ib1 according to the staging scheme of the International Federation of Gynecology and Obstetrics (FIGO 2009). INTERVENTIONS Two patients underwent ureteral branch-sparing radical hysterectomy. During surgery, indocyanine green (ICG) fluorescence angiography was used to identify the ureteral branch and evaluate perfusion of the uterine artery, its ureteral branch and the ureter. OUTCOMES The uterine artery and ureteral branch were clearly labeled by green fluorescence, as were the distal serous layer of the ureter and tissue supplied by the ureteral branch. During 4-month follow-up, neither patient suffered hydronephrosis, ureteral fistula or stricture. LESSONS ICG angiography is a useful intraoperative imaging technique for identifying the ureteral branch and evaluating the branch-sparing surgery. Based on real-time angiography, sparing the ureteral branch can maintain blood supply to the ureter distal serous layer and neighboring tissues.
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Mery E, Golzio M, Guillermet S, Lanore D, Le Naour A, Thibault B, Tilkin-Mariamé AF, Bellard E, Delord JP, Querleu D, Ferron G, Couderc B. Fluorescence-guided surgery for cancer patients: a proof of concept study on human xenografts in mice and spontaneous tumors in pets. Oncotarget 2017; 8:109559-109574. [PMID: 29312629 PMCID: PMC5752542 DOI: 10.18632/oncotarget.22728] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/28/2017] [Indexed: 12/11/2022] Open
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.
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Affiliation(s)
- Eliane Mery
- Institut Claudius Regaud -IUCT Oncopole, University Toulouse III, Toulouse, France
| | - Muriel Golzio
- Institut de Pharmacologie et de Biologie Structurale, Université de Toulouse, Toulouse, France
| | | | | | - Augustin Le Naour
- Institut Claudius Regaud -IUCT Oncopole, University Toulouse III, Toulouse, France
| | - Benoît Thibault
- Institut Claudius Regaud -IUCT Oncopole, University Toulouse III, Toulouse, France
| | | | - Elizabeth Bellard
- Institut de Pharmacologie et de Biologie Structurale, Université de Toulouse, Toulouse, France
| | - Jean Pierre Delord
- Institut Claudius Regaud -IUCT Oncopole, University Toulouse III, Toulouse, France
| | - Denis Querleu
- Institut Claudius Regaud -IUCT Oncopole, University Toulouse III, Toulouse, France
| | - Gwenael Ferron
- Institut Claudius Regaud -IUCT Oncopole, University Toulouse III, Toulouse, France
| | - Bettina Couderc
- Institut Claudius Regaud -IUCT Oncopole, University Toulouse III, Toulouse, France
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Gan Q, Wang D, Ye J, Zhang Z, Wang X, Hu C, Shao P, Xu RX. Benchtop and Animal Validation of a Projective Imaging System for Potential Use in Intraoperative Surgical Guidance. PLoS One 2016; 11:e0157794. [PMID: 27391764 PMCID: PMC4938571 DOI: 10.1371/journal.pone.0157794] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 06/03/2016] [Indexed: 11/18/2022] Open
Abstract
We propose a projective navigation system for fluorescence imaging and image display in a natural mode of visual perception. The system consists of an excitation light source, a monochromatic charge coupled device (CCD) camera, a host computer, a projector, a proximity sensor and a Complementary metal-oxide-semiconductor (CMOS) camera. With perspective transformation and calibration, our surgical navigation system is able to achieve an overall imaging speed higher than 60 frames per second, with a latency of 330 ms, a spatial sensitivity better than 0.5 mm in both vertical and horizontal directions, and a projection bias less than 1 mm. The technical feasibility of image-guided surgery is demonstrated in both agar-agar gel phantoms and an ex vivo chicken breast model embedding Indocyanine Green (ICG). The biological utility of the system is demonstrated in vivo in a classic model of ICG hepatic metabolism. Our benchtop, ex vivo and in vivo experiments demonstrate the clinical potential for intraoperative delineation of disease margin and image-guided resection surgery.
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Affiliation(s)
- Qi Gan
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Dong Wang
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, United States of America
| | - Jian Ye
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Zeshu Zhang
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Xinrui Wang
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Chuanzhen Hu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
| | - Pengfei Shao
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- * E-mail: (PS); (RXX)
| | - Ronald X. Xu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, United States of America
- * E-mail: (PS); (RXX)
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Josserand V, Kéramidas M, Lavaud J, Righini C, Vollaire J, Bellard E, Rols MP, Teissié J, Coll JL, Golzio M. Electrochemotherapy guided by intraoperative fluorescence imaging for the treatment of inoperable peritoneal micro-metastases. J Control Release 2016; 233:81-7. [PMID: 27155365 DOI: 10.1016/j.jconrel.2016.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/25/2016] [Accepted: 05/01/2016] [Indexed: 01/15/2023]
Abstract
Surgery is often the first therapeutic indication in cancer. Patient survival essentially depends on the completeness of tumor resection. This is a major challenge, particularly in patients with peritoneal carcinomatosis (PC), where tumors are widely disseminated in the large peritoneal cavity. These small tumors can be difficult to visualize and are often positioned in delicate locations, further increasing the risk of producing serious tissue/organ damage during their ablation. We propose an innovative therapeutic approach based on intraoperative fluorescence (IF) guided electrochemotherapy (ECT) for the treatment of peritoneal micro-metastases. ECT combines the effects of tissue electro-permeabilization (EP) with the administration of an antimitotic agent (bleomycin) that has poor permeability across intact membranes. IF significantly improves the detection of small tumor lesions. ECT is clinically validated for the treatment of cutaneous tumors in animals and humans, but this is the first time that it has been used along with IF imaging for the targeted treatment of peritoneal metastases in a preclinical model. We set up a murine model of PC that develops secondarily to the resection of a distant primary tumor. Tumor growth and metastasis were finely monitored by non-invasive multimodal imaging (bioluminescence and 3D fluorescence/microCT). Once metastases were detected, mice were randomized into three groups: the ECT group (bleomycin injected intravenously followed by EP) and 2 control groups (bleomycin alone and EP alone). Twenty four hours after the intravenous injection of the tumor targeting agent Angiostamp™700, mice in all groups underwent an abdominal surgery for metastases exploration assisted by fluorescence imaging with the Fluobeam®700 portative device. EP was applied to every nodule detected by IF, except in the bleomycin control group. After surgery, the metastatic invasion was tracked by bioluminescence imaging. In mice treated with bleomycin or EP alone, the metastatic load progressed very rapidly and mice showed no significant difference in lifespan compared to non-operated mice (median lifespan: 27days vs. 25days, respectively). In contrast, the mice treated with ECT displayed a decreased metastatic load and an increased survival rate (median lifespan: 34days). These results provide evidence that IF guided ECT is an effective approach for the treatment of inoperable intraperitoneal micro-metastases.
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Affiliation(s)
- V Josserand
- INSERM U1209, Institut Albert Bonniot, F-38000 Grenoble, France; Univ. Grenoble Alpes, Institut Albert Bonniot, F-38000 Grenoble, France
| | - M Kéramidas
- INSERM U1209, Institut Albert Bonniot, F-38000 Grenoble, France; Univ. Grenoble Alpes, Institut Albert Bonniot, F-38000 Grenoble, France
| | - J Lavaud
- INSERM U1209, Institut Albert Bonniot, F-38000 Grenoble, France; Univ. Grenoble Alpes, Institut Albert Bonniot, F-38000 Grenoble, France
| | - C Righini
- INSERM U1209, Institut Albert Bonniot, F-38000 Grenoble, France; Univ. Grenoble Alpes, Institut Albert Bonniot, F-38000 Grenoble, France; CHU, Grenoble, France
| | - J Vollaire
- INSERM U1209, Institut Albert Bonniot, F-38000 Grenoble, France; Univ. Grenoble Alpes, Institut Albert Bonniot, F-38000 Grenoble, France
| | - E Bellard
- CNRS, IPBS, Toulouse, France; Université de Toulouse, UPS, IPBS, Toulouse, France
| | - M P Rols
- CNRS, IPBS, Toulouse, France; Université de Toulouse, UPS, IPBS, Toulouse, France
| | - J Teissié
- CNRS, IPBS, Toulouse, France; Université de Toulouse, UPS, IPBS, Toulouse, France
| | - J L Coll
- INSERM U1209, Institut Albert Bonniot, F-38000 Grenoble, France; Univ. Grenoble Alpes, Institut Albert Bonniot, F-38000 Grenoble, France.
| | - M Golzio
- CNRS, IPBS, Toulouse, France; Université de Toulouse, UPS, IPBS, Toulouse, France.
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Swanson KI, Clark PA, Zhang RR, Kandela IK, Farhoud M, Weichert JP, Kuo JS. Fluorescent cancer-selective alkylphosphocholine analogs for intraoperative glioma detection. Neurosurgery 2015; 76:115-23; discussion 123-4. [PMID: 25549194 DOI: 10.1227/neu.0000000000000622] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND 5-Aminolevulinic acid (5-ALA)-induced tumor fluorescence aids brain tumor resections but is not approved for routine use in the United States. We developed and describe testing of 2 novel fluorescent, cancer-selective alkylphosphocholine analogs, CLR1501 (green) and CLR1502 (near infrared), in a proof-of-principle study for fluorescence-guided glioma surgery. OBJECTIVE To demonstrate that CLR1501 and CLR1502 are cancer cell-selective fluorescence agents in glioblastoma models and to compare tumor-to-normal brain (T:N) fluorescence ratios with 5-ALA. METHODS CLR1501, CLR1502, and 5-ALA were administered to mice with magnetic resonance imaging-verified orthotopic U251 glioblastoma multiforme- and glioblastoma stem cell-derived xenografts. Harvested brains were imaged with confocal microscopy (CLR1501), the IVIS Spectrum imaging system (CLR1501, CLR1502, and 5-ALA), or the Fluobeam near-infrared fluorescence imaging system (CLR1502). Imaging and quantitative analysis of T:N fluorescence ratios were performed. RESULTS Excitation/emission peaks are 500/517 nm for CLR1501 and 760/778 nm for CLR1502. The observed T:N ratio for CLR1502 (9.28±1.08) was significantly higher (P<.01) than for CLR1501 (3.51±0.44 on confocal imaging; 7.23±1.63 on IVIS imaging) and 5-ALA (4.81±0.92). Near-infrared Fluobeam CLR1502 imaging in a mouse xenograft model demonstrated high- contrast tumor visualization compatible with surgical applications. CONCLUSION CLR1501 (green) and CLR1502 (near infrared) are novel tumor-selective fluorescent agents for discriminating tumor from normal brain. CLR1501 exhibits a tumor-to-brain fluorescence ratio similar to that of 5-ALA, whereas CLR1502 has a superior tumor-to-brain fluorescence ratio. This study demonstrates the potential use of CLR1501 and CLR1502 in fluorescence-guided tumor surgery.
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Affiliation(s)
- Kyle I Swanson
- *Department of Neurological Surgery, ‡Cellular and Molecular Biology Training Program, ¶Department of Radiology, ‖Department Medical Physics, and #Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; §Cellectar Biosciences, Inc, Madison, Wisconsin; **Department of Surgery, National University of Singapore, Singapore
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Quici S, Casoni A, Foschi F, Armelao L, Bottaro G, Seraglia R, Bolzati C, Salvarese N, Carpanese D, Rosato A. Folic acid-conjugated europium complexes as luminescent probes for selective targeting of cancer cells. J Med Chem 2015; 58:2003-14. [PMID: 25602505 DOI: 10.1021/jm501945w] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
We report the synthesis of three optical probes (Eu(3+)⊂1, Eu(3+)⊂2, and Eu(3+)⊂3) having a luminescent Eu complex (signaling unit) bonded in different positions to folic acid (FA), the folate receptor (FR) targeting unit. The structures of the two regioisomers Eu(3+)⊂1 and Eu(3+)⊂2 were assigned by mass spectrometric experiments. The optical properties and stability of these probes were assessed in phosphate-buffered saline, cell culture medium, rat serum, and cellular lysate, and results indicated that they are chemically and photophysically stable. Cytotoxicity was studied with ovarian cancer cells having high (SKOV-3), intermediate (OVCAR-3), low (IGROV-1), or null (A2780) expression of FRs. The internalized probe, evaluated in SKOV-3, IGROV-1, and A2780 cells, was in the order Eu(3+)⊂2 > Eu(3+)⊂1 > Eu(3+)⊂3. No internalization was observed for A2780 cells. Such results, together with those obtained in competition experiments of FA versus Eu(3+)⊂2 and FA or Eu(3+)⊂2 versus (3)H-FA, indicate that internalization is receptor-mediated and that Eu(3+)⊂2 shows high selectivity and specificity for FR.
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Affiliation(s)
- Silvio Quici
- Istituto di Scienze e Tecnologie Molecolari, Consiglio Nazionale delle Ricerche , Via C. Golgi 19, 20133 Milano, Italy
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Maximal cytoreduction in patients with FIGO stage IIIC to stage IV ovarian, fallopian, and peritoneal cancer in day-to-day practice: a Retrospective French Multicentric Study. Int J Gynecol Cancer 2013; 22:1337-43. [PMID: 22964527 DOI: 10.1097/igc.0b013e31826a3559] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To evaluate the outcome of maximal cytoreductive surgery in patients with stage IIIC to stage IV ovarian, tubal, and peritoneal cancer regarding overall survival (OS) and disease-free survival (DFS). MATERIALS AND METHODS Five hundred twenty-seven patients with stage IIIC (peritoneal) and stage IV (pleural) ovarian, fallopian tube, and peritoneal carcinoma underwent surgery between January 2003 and December 2007 in 7 gynecologic oncology centers in France. Patients undergoing primary and interval debulking surgery were included, whichever the number of chemotherapy cycles. The extent of disease, type of surgical procedure, and amount of residual disease were recorded. A multivariate analysis of the outcome was performed, taking into account the stage, grade, and timing of surgery. RESULTS Median DFS was 17.9 months, but median OS was not reached at the time of analysis. Complete cytoreductive surgery, without evident residual tumor at the end of the procedure, was obtained in 71% of all patients (primary surgery, 33%). After neoadjuvant therapy, the rate of complete debulking surgery was higher (74%) compared to primary cytoreductive surgery (65%). Twenty-three percent of patients needed "ultra radical surgery" to achieve this goal. The most significant predictive factor for DFS and OS was complete cytoreductive surgery compared to any amount, even minimal (1-10 mm), of residual disease. In the group of patients with complete cytoreductive surgery, the patients undergoing surgery before chemotherapy showed better DFS than those having first chemotherapy. CONCLUSION The findings confirm that complete cytoreduction is the criterion standard of surgery in the management of advanced ovarian, peritoneal, and fallopian tube cancer, whatever the timing of surgery. With experienced teams, surgery was completed, without evident residual tumor in 71% of the cases.
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Pich C, Teiti I, Rochaix P, Mariamé B, Couderc B, Favre G, Tilkin-Mariamé AF. Statins Reduce Melanoma Development and Metastasis through MICA Overexpression. Front Immunol 2013; 4:62. [PMID: 23493799 PMCID: PMC3595569 DOI: 10.3389/fimmu.2013.00062] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 02/27/2013] [Indexed: 11/13/2022] Open
Abstract
Survival of melanoma patients after metastases detection remains short. Several clinical trials have shown moderate efficiency in improving patient survival, and the search for pharmacological agents to enhance the immune response and reduce melanoma metastases is still necessary. Statins block the mevalonate pathway, which leads to decreases in GTPase isoprenylation and activity, particularly those of the Ras superfamily. They are widely used as hypocholesterolemic agents in cardiovascular diseases and several studies have shown that they also have protective effects against cancers. Furthermore, we have previously demonstrated that treatment of melanoma cells with inhibitors of the mevalonate pathway, such as statins, favor the development of specific adaptive immune responses against these tumors. In the present study, we tested statin impact on the innate immune response against human metastatic melanoma cells. Our data shows that treatment of two human melanoma cell lines with statins induced a weak but significant increase of MHC class I Chain-related protein A (MICA) membrane expression. Peroxisome Proliferator-Activated Receptor gamma is involved in this statin-induced MICA overexpression, which is independent of Ras and Rho GTPase signaling pathways. Interestingly, this MICA overexpression makes melanoma cells more sensitive to in vitro lysis by NK cells. The impact of statin treatment on in vivo development of melanoma tumors and metastases was investigated in nude mice, because murine NK cells, which express NKG2D receptors, are able to recognize and kill human tumor cells expressing MICA. The results demonstrated that both local tumor growth and pulmonary metastases were strongly inhibited in nude mice injected with statin-treated melanoma cells. These results suggest that statins could be effective in melanoma immunotherapy treatments.
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Affiliation(s)
- Christine Pich
- INSERM/UPS UMR 1037, Cancer Research Center of Toulouse Toulouse, France ; Institut Claudius Regaud Toulouse, France ; Université Paul Sabatier Toulouse, France
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Ulrich S, Dumy P, Boturyn D, Renaudet O. Engineering of biomolecules for sensing and imaging applications. J Drug Deliv Sci Technol 2013. [DOI: 10.1016/s1773-2247(13)50001-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Harlaar NJ, Kelder W, Sarantopoulos A, Bart J, Themelis G, van Dam GM, Ntziachristos V. Real-time near infrared fluorescence (NIRF) intra-operative imaging in ovarian cancer using an α(v)β(3-)integrin targeted agent. Gynecol Oncol 2012; 128:590-5. [PMID: 23262209 DOI: 10.1016/j.ygyno.2012.12.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 12/02/2012] [Accepted: 12/08/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND In ovarian cancer, optimal cytoreductive surgery is of the utmost importance for long-term survival. The ability to visualize minuscule tumor deposits is important to ensure complete resection of the tumor. The purpose of our study was to estimate the in vivo sensitivity, specificity and diagnostic accuracy of an intra-operative fluorescence imaging system combined with an α(v)β(3)-integrin targeted near-infrared fluorescent probe. METHOD Tumor bearing mice were injected intravenously with a fluorescent probe targeting α(v)β(3) integrins. Fluorescent spots and non-fluorescent tissue were identified and resected. Standard histopathology and fluorescence microscopy were used as gold-standard for tumor detection. RESULTS Fifty-eight samples excised with support of intra-operative image-guided surgery were analyzed. The mean target to background ratio was 2.2 (SD 0.5). The calculated sensitivity of the imaging system was 95%, and the specificity was 88% with a diagnostic accuracy of 96.5%. CONCLUSION Near-infrared image-guided surgery in this model has a high diagnostic accuracy and a fair target to background ratio that supports the development towards clinical translation of α(v)β(3)-integrin targeted imaging.
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Affiliation(s)
- N J Harlaar
- Biological Imaging & Institute for Medical and Biological Imaging, Technische Universität München and Helmholtz Zentrum München, Munich, Germany.
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Wenk CHF, Ponce F, Guillermet S, Tenaud C, Boturyn D, Dumy P, Watrelot-Virieux D, Carozzo C, Josserand V, Coll JL. Near-infrared optical guided surgery of highly infiltrative fibrosarcomas in cats using an anti-αvß3 integrin molecular probe. Cancer Lett 2012. [PMID: 23200675 DOI: 10.1016/j.canlet.2012.10.041] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We investigated how near-infrared imaging could improve highly infiltrative spontaneous fibrosarcoma surgery in 12 cats in a clinical veterinary phase. We used an RGD-based nanoprobe at different doses and times before surgery and a portable clinical grade imaging system. All tumours were labelled by the tracer and had an overall tumour-to-healthy tissue ratio of 14±1 during surgery. No false negatives were found, and the percentage of tumour cells was linearly correlated with the fluorescence intensity. All cats recovered well and were submitted to long-term follow-up that is currently on-going 1year after the beginning of the study.
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Affiliation(s)
- Christiane H F Wenk
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 823, Institut Albert Bonniot, Grenoble, France; Université Joseph Fourier (UJF), Grenoble, France
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Abstract
PURPOSE OF REVIEW Fluorescent tracers can provide anatomical and functional information without altering the visual surgical field. Despite the advances that are being made in tracer development, only a few fluorescent tracers are available for urological interventions. RECENT FINDINGS Protoporphyrin IX, hypericin, fluorescein, and indocyanine green were shown to facilitate surgical resection in various ways. Hybrid imaging agents, combining radio and fluorescent labels, have shown improved integration between preoperative and intraoperative imaging. With the rise of surgical fluorescence guidance, various camera systems have been developed that are tailored for optimal detection of the fluorochromes of interest. SUMMARY In this review, the basics of fluorescence-guided surgery, including tracer and hardware requirements are discussed.
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Integrin-mediated cell-matrix interaction in physiological and pathological blood vessel formation. JOURNAL OF ONCOLOGY 2011; 2012:125278. [PMID: 21941547 PMCID: PMC3175391 DOI: 10.1155/2012/125278] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 07/15/2011] [Indexed: 02/07/2023]
Abstract
Physiological as well as pathological blood vessel formation are fundamentally dependent on cell-matrix interaction. Integrins, a family of major cell adhesion receptors, play a pivotal role in development, maintenance, and remodeling of the vasculature. Cell migration, invasion, and remodeling of the extracellular matrix (ECM) are integrin-regulated processes, and the expression of certain integrins also correlates with tumor progression. Recent advances in the understanding of how integrins are involved in the regulation of blood vessel formation and remodeling during tumor progression are highlighted. The increasing knowledge of integrin function at the molecular level, together with the growing repertoire of integrin inhibitors which allow their selective pharmacological manipulation, makes integrins suited as potential diagnostic markers and therapeutic targets.
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