This Academic-Industrial Partnership (AIP) for the development and translation of molecularly-targeted optically-fluorescent imaging agents, GMP-produced for guiding surgical resection in phase 0 clinical trials. While recent advances in the technology for guiding surgical oncology will establish an efficient pipeline have been impressive, significant limitations remain in determining, intraoperatively, the biological margins of disease. Fluorescence-guided surgical resection based on protoporphyrin IX production in high-grade gliomas has highlighted the potential promise of the approach to the extent that intraoperative fluorescence imaging, with both red and infrared channels, is now available on state-of-the-art surgical microscopes manufactured by Leica and Zeiss. Despite these rapid advances, development of the molecular tracers that are required to guide surgical procedures has been lacking. The basis of this application and the underlying tenet of the proposed AIP are that a cost-effective, risk-diluted approach to and cost-effective testing contrast agent development and are needed in order to realize the promise of fluorescence-guidance during surgery. The testing will be carried out with end-points of surgical testing in phase 0 micro dosing studies signal detection and binding specificity being the primary outcomes from the phase 0 trials. Rapid testing is critical because most agents will not be successful, and we need a strategy to reduce the time, cost and risk required to quickly assess targeting efficacy in early human surgical trials. Creation of such a pipeline process stands to accelerate dramatically the paradigm shift to molecular-guided surgical oncology that will revolutionize both the procedures that are possible and the surgical outcomes that will result. The proposed AIP between Dartmouth (Engineering and Medical Schools), Affibody AB, and LI-COR brings together 3 partners who have the intellectual property (IP), expertise and infrastructure to develop, test and advance molecularly-targeted fluorescent tracers for surgical guidance. The first agent we will advance will be an affibody molecule (created and extensively characterized in animals by Affibody, AB, and currently undergoing nuclear imaging studies in humans) targeted to the epidermal growth factor receptor (EGFR) conjugated with a fluorescent dye (systematically developed by LI-COR for human use) with absorption and emission spectra in the near infrared. The compound will be developed and produced through peptide synthesis under GMP conditions, single administration toxicity testing in requisite animal models will be completed, and a first-in-human phase 0 dose escalation study will be pursued at Dartmouth under exploratory investigational new drug (eIND) approval from the FDA.
This proposal will develop a partnership pipeline for development and testing of agents for molecular fluorescence-guided surgery, joining together companies Affibody AB, LI-COR with Dartmouth Engineering and Neurosurgery. The first agent tested will be a GMP-produced peptide targeted to the EGF-receptor. All peptide synthesis, analytical testing, toxicity testing will be completed, and a phase 0 micro dosing study will be conducted in recurrent glioma patients.
|de Souza, Ana Luiza Ribeiro; Marra, Kayla; Gunn, Jason et al. (2017) Fluorescent Affibody Molecule Administered In Vivo at a Microdose Level Labels EGFR Expressing Glioma Tumor Regions. Mol Imaging Biol 19:41-48|
|Samkoe, Kimberley S; Gunn, Jason R; Marra, Kayla et al. (2017) Toxicity and Pharmacokinetic Profile for Single-Dose Injection of ABY-029: a Fluorescent Anti-EGFR Synthetic Affibody Molecule for Human Use. Mol Imaging Biol 19:512-521|
|Elliott, Jonathan T; Marra, Kayla; Evans, Linton T et al. (2017) Simultaneous In Vivo Fluorescent Markers for Perfusion, Protoporphyrin Metabolism, and EGFR Expression for Optically Guided Identification of Orthotopic Glioma. Clin Cancer Res 23:2203-2212|
|Elliott, Jonathan T; Samkoe, Kimberley S; Davis, Scott C et al. (2016) Image-derived arterial input function for quantitative fluorescence imaging of receptor-drug binding in vivo. J Biophotonics 9:282-95|
|Holt, Robert W; Demers, Jennifer-Lynn H; Sexton, Kristian J et al. (2015) Tomography of epidermal growth factor receptor binding to fluorescent Affibody in vivo studied with magnetic resonance guided fluorescence recovery in varying orthotopic glioma sizes. J Biomed Opt 20:26001|
|Tichauer, Kenneth M; Wang, Yu; Pogue, Brian W et al. (2015) Quantitative in vivo cell-surface receptor imaging in oncology: kinetic modeling and paired-agent principles from nuclear medicine and optical imaging. Phys Med Biol 60:R239-69|
|Pogue, Brian W; Paulsen, Keith D; Hull, Sally M et al. (2015) Advancing Molecular-Guided Surgery through probe development and testing in a moderate cost evaluation pipeline. Proc SPIE Int Soc Opt Eng 9311:|