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Mani L, Naveed A, McAdoo A, Rosenthal E, Hom M. Efficacy of Depatuxizumab Mafodotin (ABT-414) in preclinical models of head and neck cancer. Carcinogenesis 2024:bgae014. [PMID: 38375733 DOI: 10.1093/carcin/bgae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Indexed: 02/21/2024] Open
Abstract
Epidermal growth factor receptor (EGFR) is highly expressed in 80-90% of head and neck squamous cell carcinomas (HNSCCs), making it an ideal target for antibody-drug conjugates (ADCs). Depatuxizumab mafodotin (ABT-414), is an EGFR-targeting ADC comprised of the monoclonal antibody (mAb) ABT-806 conjugated to monomethyl auristatin F, a tubulin polymerization inhibitor. This study assessed the in vivo efficacy of ABT-414 in HNSCC. The effects of ABT-414 on HNSCCs were determined using in vitro cytotoxicity assays and in vivo flank xenograft mouse models. The distribution of ABT-414 was assessed ex vivo via optical imaging methods using a conjugate of ABT-414 to the near-infrared agent IRDye800. In vitro treatment of high EGFR-expressing human HNSCC cell lines (UMSCC47 and FaDu) with ABT-414 (0-3.38 nM) resulted in dose-dependent cell death (IC50 values of 0.213 nM and 0.167 nM, respectively). ABT-414 treatment of the FaDu mouse xenografts displayed antitumor activity (p= 0.023) without a change in body mass (p= 0.1335), whereas treatment of UMSCC47 did not generate a significant response (p = 0.1761). Fluorescence imaging revealed ABT-414-IRDye800 accumulation in the tumors of both FaDu and UMSCC47 cell lines, with a signal-to-background ratio of >10. ABT-414 treatment yielded antitumor activity in FaDu tumors, but not in UMSCC47, highlighting the potential for ABT-414 efficacy in high EGFR-expressing tumors. While ABT-414-IRDye800 localized tumors in both cell lines, the differing antitumor responses highlight the need for further investigation into the role of the tumor microenvironment in drug delivery.
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Affiliation(s)
- Lucas Mani
- Department of Otolaryngology, Vanderbilt University, Nashville, United States
| | - Abdullah Naveed
- Department of Otolaryngology, Vanderbilt University, Nashville, United States
| | - Ashtyn McAdoo
- Department of Otolaryngology, Vanderbilt University, Nashville, United States
| | - Eben Rosenthal
- Department of Otolaryngology, Vanderbilt University, Nashville, United States
| | - Marisa Hom
- Department of Otolaryngology, Vanderbilt University, Nashville, United States
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2
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Crawford KL, Lee YJ, Hom M, Rosenthal EL, Orosco RK, Nguyen QT. Identification of Degenerated Murine Facial Nerves With Fluorescence Labeling After Transection Injury. Otolaryngol Head Neck Surg 2023; 169:234-242. [PMID: 36758958 DOI: 10.1002/ohn.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/08/2022] [Accepted: 12/24/2022] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Delayed peripheral nerve repair is complicated by nerve degeneration and atrophy that can prevent identification. We use a murine facial nerve transection model to demonstrate the efficacy of ALM-488 (bevonescein) in labeling degenerated facial nerves with quantitative image analysis and qualitative survey data. STUDY DESIGN Prospective cohort study. SETTING Laboratory. METHODS Ten wild-type mice underwent transection of the lower facial nerve division with subsequent degeneration. Either 9 (n = 5 mice) or 12 (n = 5 mice) weeks later, mice underwent intravenous infusion of ALM-488 with in vivo real-time fluorescence imaging (FL) of the facial nerve. Using ImageJ, the mean gray value of each nerve segment under white light reflectance (WLR) and FL was compared to that of adjacent soft tissue to calculate the signal-to-background ratio (SBR). A survey was distributed to evaluate the perceived utility of ALM-488 in surgeon identification of degenerated nerves. RESULTS The mean SBR of degenerated nerves was 1.08 (standard deviation [SD]: 0.07) under WLR and 2.11 (SD: 0.31) under FL (p < 0.001). In mice with degenerated nerves, survey participants identified on average 3.01 (SD: 1.84) nerve branches under WLR and 5.73 (SD: 1.88) under FL (p < 0.0001). Under FL, 47 of 48 survey responses correctly identified isolated, degenerated nerves; in contrast, only 12 responses identified degenerated nerves under WLR (p < 0.0001). CONCLUSION Preoperative intravenous infusion of ALM-488 with FL improves the identification of degenerated facial nerves. ALM-488 also improves surgeon confidence in nerve identification, particularly in degenerated nerve branches that are not visible with WLR.
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Affiliation(s)
- Kayva L Crawford
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, USA
| | - Yu-Jin Lee
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Marisa Hom
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Eben L Rosenthal
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, USA
| | - Ryan K Orosco
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, USA
- Hanna and Mark Gleiberman Head and Neck Cancer Center, Moores Cancer Center, University of California San Diego, California, San Diego, USA
| | - Quyen T Nguyen
- Department of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, USA
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Van Keulen S, Hom M, White H, Rosenthal EL, Baik FM. The Evolution of Fluorescence-Guided Surgery. Mol Imaging Biol 2023; 25:36-45. [PMID: 36123445 PMCID: PMC9971137 DOI: 10.1007/s11307-022-01772-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 10/14/2022]
Abstract
There has been continual development of fluorescent agents, imaging systems, and their applications over the past several decades. With the recent FDA approvals of 5-aminolevulinic acid, hexaminolevulinate, and pafolacianine, much of the potential that fluorescence offers for image-guided oncologic surgery is now being actualized. In this article, we review the evolution of fluorescence-guided surgery, highlight the milestones which have contributed to successful clinical translation, and examine the future of targeted fluorescence imaging.
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Affiliation(s)
- Stan Van Keulen
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marisa Hom
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Haley White
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eben L Rosenthal
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fred M Baik
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
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Lee YJ, van den Berg NS, Duan H, Azevedo EC, Ferri V, Hom M, Raymundo RC, Valencia A, Castillo J, Shen B, Zhou Q, Freeman L, Koran ME, Kaplan MJ, Colevas AD, Baik FM, Chin FT, Martin BA, Iagaru A, Rosenthal EL. 89Zr-panitumumab Combined With 18F-FDG PET Improves Detection and Staging of Head and Neck Squamous Cell Carcinoma. Clin Cancer Res 2022; 28:4425-4434. [PMID: 35929985 DOI: 10.1158/1078-0432.ccr-22-0094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/16/2022] [Accepted: 08/02/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Determine the safety and specificity of a tumor-targeted radiotracer (89Zr-pan) in combination with 18F-FDG PET/CT to improve diagnostic accuracy in head and neck squamous cell carcinoma (HNSCC). EXPERIMENTAL DESIGN Adult patients with biopsy-proven HNSCC scheduled for standard-of-care surgery were enrolled in a clinical trial and underwent systemic administration of 89Zirconium-panitumumab and panitumumab-IRDye800 followed by preoperative 89Zr-pan PET/CT and intraoperative fluorescence imaging. The sensitivity, specificity, and AUC were evaluated. RESULTS A total of fourteen patients were enrolled and completed the study. Four patients (28.5%) had areas of high 18F-FDG uptake outside the head and neck region with maximum standardized uptake values (SUVmax) greater than 2.0 that were not detected on 89Zr-pan PET/CT. These four patients with incidental findings underwent further workup and had no evidence of cancer on biopsy or clinical follow-up. Forty-eight lesions (primary tumor, LNs, incidental findings) with SUVmax ranging 2.0-23.6 were visualized on 18F-FDG PET/CT; 34 lesions on 89Zr-pan PET/CT with SUVmax ranging 0.9-10.5. The combined ability of 18F-FDG PET/CT and 89Zr-pan PET/CT to detect HNSCC in the whole body was improved with higher specificity of 96.3% [confidence interval (CI), 89.2%-100%] compared to 18F-FDG PET/CT alone with specificity of 74.1% (CI, 74.1%-90.6%). One possibly related grade 1 adverse event of prolonged QTc (460 ms) was reported but resolved in follow-up. CONCLUSIONS 89Zr-pan PET/CT imaging is safe and may be valuable in discriminating incidental findings identified on 18F-FDG PET/CT from true positive lesions and in localizing metastatic LNs.
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Affiliation(s)
- Yu-Jin Lee
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine. Stanford, California
| | | | - Heying Duan
- Department of Radiology, Stanford University School of Medicine. Stanford, California
| | - E Carmen Azevedo
- Department of Radiology, Stanford University School of Medicine. Stanford, California
| | - Valentina Ferri
- Department of Radiology, Stanford University School of Medicine. Stanford, California
| | - Marisa Hom
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center. Nashville, Tennessee
| | - Roan C Raymundo
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine. Stanford, California
| | - Alex Valencia
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine. Stanford, California
| | - Jessa Castillo
- Department of Radiology, Stanford University School of Medicine. Stanford, California
| | - Bin Shen
- Department of Radiology, Stanford University School of Medicine. Stanford, California
| | - Quan Zhou
- Department of Neurosurgery, Stanford University School of Medicine. Stanford, California
| | - Laura Freeman
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine. Stanford, California
| | - Mary Ellen Koran
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center. Nashville, Tennessee
| | - Michael J Kaplan
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine. Stanford, California
| | - A Dimitrios Colevas
- Department of Medicine - Division of Medical Oncology, Stanford University School of Medicine. Stanford, California
| | - Fred M Baik
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine. Stanford, California
| | - Frederick T Chin
- Department of Radiology, Stanford University School of Medicine. Stanford, California
| | - Brock A Martin
- Department of Pathology, University of Louisville. Louisville, Kentucky
| | - Andrei Iagaru
- Department of Radiology, Stanford University School of Medicine. Stanford, California
| | - Eben L Rosenthal
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center. Nashville, Tennessee
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5
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Martin E, Hom M, Mani L, Rosenthal EL. Current and Future Applications of Fluorescence-Guided Surgery in Head and Neck Cancer. Surg Oncol Clin N Am 2022; 31:695-706. [DOI: 10.1016/j.soc.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Pal R, Hom M, van den Berg NS, Lwin TM, Lee YJ, Prilutskiy A, Faquin W, Yang E, Saladi SV, Varvares MA, Rosenthal EL, Kumar ATN. First Clinical Results of Fluorescence Lifetime-enhanced Tumor Imaging Using Receptor-targeted Fluorescent Probes. Clin Cancer Res 2022; 28:2373-2384. [PMID: 35302604 PMCID: PMC9167767 DOI: 10.1158/1078-0432.ccr-21-3429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/23/2021] [Accepted: 03/15/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Fluorescence molecular imaging, using cancer-targeted near infrared (NIR) fluorescent probes, offers the promise of accurate tumor delineation during surgeries and the detection of cancer specific molecular expression in vivo. However, nonspecific probe accumulation in normal tissue results in poor tumor fluorescence contrast, precluding widespread clinical adoption of novel imaging agents. Here we present the first clinical evidence that fluorescence lifetime (FLT) imaging can provide tumor specificity at the cellular level in patients systemically injected with panitumumab-IRDye800CW, an EGFR-targeted NIR fluorescent probe. EXPERIMENTAL DESIGN We performed wide-field and microscopic FLT imaging of resection specimens from patients injected with panitumumab-IRDye800CW under an FDA directed clinical trial. RESULTS We show that the FLT within EGFR-overexpressing cancer cells is significantly longer than the FLT of normal tissue, providing high sensitivity (>98%) and specificity (>98%) for tumor versus normal tissue classification, despite the presence of significant nonspecific probe accumulation. We further show microscopic evidence that the mean tissue FLT is spatially correlated (r > 0.85) with tumor-specific EGFR expression in tissue and is consistent across multiple patients. These tumor cell-specific FLT changes can be detected through thick biological tissue, allowing highly specific tumor detection and noninvasive monitoring of tumor EFGR expression in vivo. CONCLUSIONS Our data indicate that FLT imaging is a promising approach for enhancing tumor contrast using an antibody-targeted NIR probe with a proven safety profile in humans, suggesting a strong potential for clinical applications in image guided surgery, cancer diagnostics, and staging.
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Affiliation(s)
- Rahul Pal
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 13 Street, Building 149, Charlestown MA 02129
| | - Marisa Hom
- Department of Otolaryngology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232
| | | | - Thinzar M Lwin
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston MA
| | - Yu-Jin Lee
- Department of Otolaryngology, Stanford University School of Medicine, 900 Blake Wilbur Drive, Stanford CA
| | - Andrey Prilutskiy
- Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison WI
| | - William Faquin
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston MA
| | - Eric Yang
- Department of Pathology, Stanford University School of Medicine, 900 Blake Wilbur Drive, Stanford CA
| | - Srinivas V. Saladi
- Department of Otolaryngology and Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 55 Fruit Street, Boston MA
| | - Mark A. Varvares
- Department of Otolaryngology and Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 55 Fruit Street, Boston MA
| | - Eben L. Rosenthal
- Department of Otolaryngology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232
| | - Anand T. N. Kumar
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 13 Street, Building 149, Charlestown MA 02129
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Zhou Q, van den Berg NS, Kang W, Pei J, Nishio N, van Keulen S, Engelen MA, Lee YJ, Hom M, Vega Leonel JCM, Hart Z, Vogel H, Cayrol R, Martin BA, Roesner M, Shields G, Lui N, Hayden Gephart M, Raymundo RC, Yi G, Granucci M, Grant GA, Li G, Rosenthal EL. Factors for differential outcome across cancers in clinical molecular-targeted fluorescence imaging. J Nucl Med 2022; 63:1693-1700. [PMID: 35332092 PMCID: PMC9635681 DOI: 10.2967/jnumed.121.263674] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/22/2022] [Indexed: 11/16/2022]
Abstract
Clinical imaging performance using a fluorescent antibody was compared across three cancers to elucidate physical and biological factors contributing to differential translation of epidermal growth factor receptor (EGFR) expression to macroscopic fluorescence in tumors. Methods: Thirty-one patients with high-grade glioma (HGG, n = 5), head-and-neck squamous cell carcinoma (HNSCC, n = 23) or lung adenocarcinoma (LAC, n = 3) were systemically infused with 50 mg panitumumab-IRDye800, 1 - 3 days prior to surgery. Intraoperative open-field fluorescent images of the surgical field were acquired, where imaging device settings and operating room lighting conditions were tested on tissue-mimicking phantoms. Fluorescence contrast and margin size were measured on resected specimen surface. Antibody distribution and EGFR immunoreactivity were characterized in macroscopic and microscopic histological structures. Integrity of the blood-brain barrier (BBB) was examined via tight junction protein (claudin-5) expression with immunohistochemistry. Stepwise multivariate linear regression of biological variables was performed to identify independent predictors of panitumumab-IRDye800 concentration in tissue. Results: Optimally acquired at the lowest gain for tumor detection with ambient light, intraoperative fluorescence imaging enhanced tissue-size dependent tumor contrast by 5.2-fold, 3.4-fold and 1.4-fold in HGG, HNSCC and LAC, respectively. Tissue surface fluorescence target-to-background ratio correlated with margin size and identified 78 - 97% of at-risk resection margins ex vivo. In 4 µm-thick tissue sections, fluorescence detected tumor with 0.85 - 0.89 areas under the receiver operating characteristic curves. Preferential breakdown of BBB in HGG improved tumor specificity of intratumoral antibody distribution relative to that of EGFR (96% vs 80%) despite its reduced concentration (3.9 ng/mg tissue) compared to HNSCC (8.1 ng/mg) and LAC (6.3 ng/mg). Cellular EGFR expression, tumor cell density, plasma antibody concentration and delivery barrier were independently associated with local intratumoral panitumumab-IRDye800 concentration with 0.62 goodness-of-fit of prediction. Conclusion: In multi-cancer clinical imaging of receptor-ligand based molecular probe, plasma antibody concentration, delivery barrier, as well as intratumoral EGFR expression driven by cellular biomarker expression and tumor cell density, led to heterogeneous intratumoral antibody accumulation and spatial distribution while tumor size, resection margin, and intraoperative imaging settings substantially influenced macroscopic tumor contrast.
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Affiliation(s)
- Quan Zhou
- Department of Neurosurgery, Stanford University School of Medicine, United States
| | | | - Wenying Kang
- Department of Otolaryngology, Stanford University School of Medicine
| | - Jacqueline Pei
- Department of Otolaryngology, Stanford University School of Medicine
| | - Naoki Nishio
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine
| | - Stan van Keulen
- Department of Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC
| | - Myrthe A Engelen
- Department of Mechanical Engineering, Delft University of Technology
| | - Yu-Jin Lee
- Department of Otolaryngology, Stanford University School of Medicine
| | - Marisa Hom
- Department of Otolaryngology, Stanford University School of Medicine
| | | | - Zachary Hart
- Department of Otolaryngology, Stanford University School of Medicine
| | | | | | | | - Mark Roesner
- Stanford Health Care, Stanford University Medical Center
| | - Glenn Shields
- Stanford Health Care, Stanford University Medical Center
| | - Natalie Lui
- Department of Cardiothoracic Surgery, Stanford University Medical Center
| | | | - Roan C Raymundo
- Cancer Clinical Trials Office, Stanford University School of Medicine
| | - Grace Yi
- Cancer Clinical Trials Office, Stanford University School of Medicine
| | - Monica Granucci
- Cancer Clinical Trials Office, Stanford University School of Medicine
| | - Gerald A Grant
- Department of Neurosurgery, Stanford University School of Medicine, United States
| | - Gordon Li
- Department of Neurosurgery, Stanford University School of Medicine, United States
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Crawford KL, Pacheco FV, Lee YJ, Hom M, Rosenthal EL, Nguyen QT, Orosco RK. A Scoping Review of Ongoing Fluorescence-Guided Surgery Clinical Trials in Otolaryngology. Laryngoscope 2021; 132:36-44. [PMID: 34633092 DOI: 10.1002/lary.29891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/17/2021] [Accepted: 09/23/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Fluorescence-guided surgery (FGS) is a rapidly developing intraoperative technology, and many contrast agents are currently under investigation. We sought to provide a review of the current state of FGS clinical trials in Otolaryngology, emphasizing its oncologic applications. METHODS According to the preferred reporting Items for systematic reviews and meta-analyses (PRISMA) workflow for scoping reviews, a clinical trial search was performed across multiple international clinical trials registries, searching for permutations of "fluorescence," "tumor," "surgery," and "nerve" to identify all relevant studies. Studies that were active, enrolling, or soon to be enrolling patients undergoing head and neck surgery were included. RESULTS Nineteen studies were eligible for inclusion. Seventeen studies are focused on FGS for oncologic resection and lymph node detection. One study assesses peripheral nerve fluorescence, and one evaluates normal parathyroid function after thyroidectomy. Contrast agents under development are conjugated to fluorophores that excite in the 800 nm (indocyanine green), 410 nm (5-aminolevulinic acid), 700 nm (Cyanine 5.5), and 525 nm ranges (fluorescein derivatives). CONCLUSION Presently, there are 19 ongoing trials investigating novel FGS contrast agents for their safety, efficacy, and utility in Otolaryngology-Head and Neck Surgery. These agents rely on unique fluorophores and absorption ranges in the near-infrared and visible light spectra. FGS studies are expanding within Otolaryngology-Head and Neck Surgery with profound implications in oncologic surgery, lymph node detection, and anatomic and functional assessment. Laryngoscope, 2021.
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Affiliation(s)
- Kayva L Crawford
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, U.S.A
| | - Fernanda V Pacheco
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, U.S.A
| | - Yu-Jin Lee
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
| | - Marisa Hom
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
| | - Eben L Rosenthal
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, U.S.A
| | - Quyen T Nguyen
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, U.S.A
| | - Ryan K Orosco
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, California, U.S.A.,Moores Cancer Center, La Jolla, California, U.S.A
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Zhou Q, van den Berg NS, Rosenthal EL, Iv M, Zhang M, Vega Leonel JCM, Walters S, Nishio N, Granucci M, Raymundo R, Yi G, Vogel H, Cayrol R, Lee YJ, Lu G, Hom M, Kang W, Hayden Gephart M, Recht L, Nagpal S, Thomas R, Patel C, Grant GA, Li G. EGFR-targeted intraoperative fluorescence imaging detects high-grade glioma with panitumumab-IRDye800 in a phase 1 clinical trial. Theranostics 2021; 11:7130-7143. [PMID: 34158840 PMCID: PMC8210618 DOI: 10.7150/thno.60582] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/24/2021] [Indexed: 12/12/2022] Open
Abstract
Rationale: First-line therapy for high-grade gliomas (HGGs) includes maximal safe surgical resection. The extent of resection predicts overall survival, but current neuroimaging approaches lack tumor specificity. The epidermal growth factor receptor (EGFR) is a highly expressed HGG biomarker. We evaluated the safety and feasibility of an anti-EGFR antibody, panitumuab-IRDye800, at subtherapeutic doses as an imaging agent for HGG. Methods: Eleven patients with contrast-enhancing HGGs were systemically infused with panitumumab-IRDye800 at a low (50 mg) or high (100 mg) dose 1-5 days before surgery. Near-infrared fluorescence imaging was performed intraoperatively and ex vivo, to identify the optimal tumor-to-background ratio by comparing mean fluorescence intensities of tumor and histologically uninvolved tissue. Fluorescence was correlated with preoperative T1 contrast, tumor size, EGFR expression and other biomarkers. Results: No adverse events were attributed to panitumumab-IRDye800. Tumor fragments as small as 5 mg could be detected ex vivo and detection threshold was dose dependent. In tissue sections, panitumumab-IRDye800 was highly sensitive (95%) and specific (96%) for pathology confirmed tumor containing tissue. Cellular delivery of panitumumab-IRDye800 was correlated to EGFR overexpression and compromised blood-brain barrier in HGG, while normal brain tissue showed minimal fluorescence. Intraoperative fluorescence improved optical contrast in tumor tissue within and beyond the T1 contrast-enhancing margin, with contrast-to-noise ratios of 9.5 ± 2.1 and 3.6 ± 1.1, respectively. Conclusions: Panitumumab-IRDye800 provided excellent tumor contrast and was safe at both doses. Smaller fragments of tumor could be detected at the 100 mg dose and thus more suitable for intraoperative imaging.
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Affiliation(s)
- Quan Zhou
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Nynke S. van den Berg
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Eben L. Rosenthal
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Center, Stanford University, Stanford, CA, USA
| | - Michael Iv
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Zhang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Shannon Walters
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Naoki Nishio
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Monica Granucci
- Cancer Clinical Trials Office, Stanford University School of Medicine, Stanford, CA, USA
| | - Roan Raymundo
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Cancer Clinical Trials Office, Stanford University School of Medicine, Stanford, CA, USA
| | - Grace Yi
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Cancer Clinical Trials Office, Stanford University School of Medicine, Stanford, CA, USA
| | - Hannes Vogel
- Department of Neuropathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Romain Cayrol
- Department of Neuropathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Yu-Jin Lee
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Guolan Lu
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Marisa Hom
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Wenying Kang
- Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Larry Recht
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Seema Nagpal
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Reena Thomas
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Chirag Patel
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Gerald A. Grant
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Gordon Li
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
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Hom M, Blake E, Takiuchi T, De Zoysa M, Machida H, Roman L, Matsuo K. Association of low-dose aspirin use and survival of women with monocytosis in endometrial cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hom M, Machida H, Adams C, Eckhardt S, Garcia J, Matsuo K. Intrauterine Manipulator Use During Minimally Invasive Hysterectomy and Risk of Lymphovascular Space Invasion in Endometrial Cancer. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.07.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hom M, Machida H, Shabalova A, Mostofizadeh S, Takiuchi T, Garcia J, Muderspach L, Matsuo K. Incidence of Urinary Tract Injury and Utility of Routine Cystoscopy during Total Laparoscopic Hysterectomy for Endometrial Cancer. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.07.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sedlis SP, Hom M, Sequeira JM, Tritel M, Gindea A, Ladenson JH, Jaffe AS, Esposito R. Time course of lysophosphatidylcholine release from ischemic human myocardium parallels the time course of early ischemic ventricular arrhythmia. Coron Artery Dis 1997; 8:19-27. [PMID: 9101118 DOI: 10.1097/00019501-199701000-00003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND We determined the kinetics of the release of lysophosphatidylcholine (LPC) into the coronary sinus of patients undergoing stress tests after coronary artery bypass grafting. The kinetics were consistent with a role for this amphiphile in the pathogenesis of ischemic ventricular arrhythmia, a major cause of sudden death. METHODS Stress testing was initiated in the operating suite by pacing at a rate of 160 beats/min for 2 min. Ischemia was then induced by clamping the bypass grafts to the anterior wall for a maximal time of 4 min. RESULTS The pacing procedure induced a prompt but reversible increase in coronary sinus LPC concentration from a baseline of 60.9 +/- 2.5 to 83.8 +/- 5.0 mumol/l via pacing alone, and a further increase to 101.8 +/- 6.7 mumol/l when the grafts were clamped for 2 min (P < 0.01). Six minutes after the cessation of pacing, LPC concentration returned to 67.5 +/- 4.4 mumol/l. CONCLUSIONS These results demonstrate that severe myocardial ischemia is an agonist for rapid release of LPC from the myocardium. Kinetics of this release paralleled the time-course of early onset of electrophysiologic changes in isolated myocytes and perfused heart preparations in vitro. These results indicate that LPC may have an important role in the pathogenesis of ischemic ventricular arrhythmia in patients.
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Affiliation(s)
- S P Sedlis
- Division of Cardiology, New York Department of Veterans Affairs Medical Center, New York, USA
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Donnenfeld A, Hom M, Bandura B, Schick B. A subscription-generated revenue support program for a teratogen information service. Reprod Toxicol 1996. [DOI: 10.1016/0890-6238(96)80195-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sedlis SP, Hom M, Sequeira JM, Esposito R. Lysophosphatidylcholine accumulation in ischemic human myocardium. J Lab Clin Med 1993; 121:111-7. [PMID: 8426072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Lysophosphatidylcholine accumulates in the coronary sinus during pacing-induced myocardial ischemia in humans. This amphiphile accelerates Ca++ flux leading to cell injury in cultured cardiac myocytes, but it is not known whether lysophosphatidylcholine accumulation is injurious to human myocardium. In this study, we measured lysophosphatidylcholine in normal human myocardium obtained during cardiac surgery and exposed to ischemic conditions in vitro. Total lysophosphatidylcholine concentration (sum of lysophosphatidylcholine remaining in tissue and lysophosphatidylcholine released into the buffer) increased from 0.73 +/- 0.08 nmol/mg protein at baseline to 1.83 +/- 0.45 nmol/mg protein after 5 minutes of ischemia (p < 0.001), and was associated with evidence of cell injury (26% depletion of tissue lactate dehydrogenase). Significant lysophosphatidylcholine release into the incubation buffer (0.41 +/- 0.11 nmol/mg protein) also occurred after 5 minutes of ischemia. In contrast, there was no lysophosphatidylcholine accumulation or release and no lactate dehydrogenase depletion in oxygenated and perfused controls. Attenuation of lysophosphatidylcholine accumulation by incubation with lysophospholipase did not prevent cell injury. Lysoplasmalogen was not detected in ischemic tissue. We conclude that lysophosphatidylcholine accumulation is a marker of myocardial ischemia in humans.
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Affiliation(s)
- S P Sedlis
- Cardiology Division, New York Department of Veterans Affairs Medical Center, NY
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Abstract
Thoracic duct injury and chylothorax are rare consequences of blunt thoracic trauma. A contained mediastinal lymph collection (ie, lymphocele) is rarer still. The article describes a case of posttraumatic mediastinal widening resulting from a high-speed motor vehicle accident. During the patient's radiologic assessment aortic rupture, paraspinal hematoma, esophageal injury, mediastinal tumor, and pseudomeningocele were sought and subsequently excluded. At this point a traumatic lymphocele was suggested, and the diagnosis was confirmed by computed tomography-guided percutaneous needle aspiration. The anatomy and physiology of the thoracic duct are reviewed.
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Affiliation(s)
- M Hom
- Department of Radiology, Medical College of Virginia Hospitals, Richmond 23298-0615
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Abstract
Umbilical arterial and venous catheters, endotracheal tubes, and nasogastric tubes are routinely used in treating premature infants, and radiologists play a critical role in evaluating proper catheter and tube placement and recognizing potential complications. Ideally, an umbilical venous catheter should be positioned in the right atrium; an umbilical arterial catheter, between T-6 and T-10 (high position) or between L-3 and L-5 (low position); an endotracheal tube, 1.5 cm above the carina, with the infant's head in a neutral position; and a nasogastric tube, in the body of the stomach. Catheters and tubes can be malpositioned in a variety of vessels and the main stem bronchi, respectively. Complications include extraluminal placement of catheters (which can result in death), thrombi in the aorta and pulmonary artery, aortic aneurysm, subglottic stenosis, intubation granuloma, and perforation of the esophagus and stomach.
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Affiliation(s)
- L D Narla
- Department of Radiology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298
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Currell DL, Nguyen DM, Ng S, Hom M. The effect of 4-isothiocyanatobenzoic acid on the oxygen-linked chloride binding sites in human hemoglobin: influence on the alkaline Bohr effect. Biochem Biophys Res Commun 1982; 106:1325-30. [PMID: 7115402 DOI: 10.1016/0006-291x(82)91258-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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