The primary goal of this pilot canine clinical trial is to translate revolutionary imaging agents for intraoperative cancer detection and image-guided surgery. Half of all cancer patients, over 700,000 annually in the US, undergo surgery to remove their tumor. The single most important predictor of patient survival is a complete surgical resection of the primary tumor, draining lymph nodes, and metastatic lesions. However, up to 40% of surgical patients leave the operating room with malignant cells remaining after resection. Thus, there are urgent unmet needs to develop new and innovative technologies that can assist the surgeon in ensuring complete tumor resection by delineating tumor margins, and identifying micrometastases and draining lymph nodes. We propose a new technology to image patients at the conclusion of the standard-of-care cancer operation in order to discover residual local disease before completing the surgery. While the proposed technologies are broadly applicable to solid tumors, this project is specifically committed to improving detection of lung adenocarcinomas, one of the most aggressive human malignancies. The proposed work will optimize a near-infrared folate targeted contrast agent and translate an intraoperative imaging approach. The folate-near infrared dye contrast agent will be optimized in a canine surgical model for spontaneous lung cancer.
This grant application develops new and innovative technologies for applications in cancer surgery. The main goal is to aid the surgeon in delineating tumor margins, identifying diseased lymph nodes and micrometastases and determining if the tumor has been completely resected. The combination of innovative folate receptor targeted contrast agents for lung adenocarcinomas and compact non-radioactive instrumentation is expected to generate a major impact (60,000 patients/year) in reducing the local and regional recurrence rates of lung cancer after surgery.