Fluorescent Agent May Help Surgeons Pinpoint Lung Tumors

A new imaging agent for lung cancer surgery can visualize residual, easy-to-miss cancer tissues that can be left behind after standard surgical resections, according to new results involving mice, canine patients, and human lung tumor samples. Lung cancer is the leading cause of death from cancer in the U.S, and patients still face a low five-year survival rate of 27%. The most effective treatment is to remove tumors via surgery during their earlier stages. However, many patients still end up with recurrence, as surgeons may miss undetectable lesions or pockets of residual cancer cells at the margins. To enhance their cancer-excising accuracy, clinicians are turning to the use of fluorescent imaging techniques, which are noninvasive and can visualize cancer tissues that might be missed with visual inspection. In this study, Sofya Osharovich and colleagues present a new agent for near-infrared fluorescent imaging for cancer surgery, named JAS239. This agent selectively binds to lung cancer cells that express ChoKα, a biomarker that is found in 60% of human lung tumors but not in healthy lung tissues. They confirmed that JAS239 could image metastatic lung lesions in mice, and then performed a veterinary trial in 20 canine patients with pre-existing lung cancer tumors. JAS239 identified close tumor margins in the dogs, and in one case spotted a hidden lesion that had evaded surgical removal of the main tumor. With an eye toward translation, Osharovich et al. also confirmed that JAS239 successfully accumulated in excised human lung tumors and highlighted regions of ChoKα expression. "These features position JAS239 as a next-generation [near-infrared fluorescent] imaging agent that integrates metabolic targeting with favorable optical and pharmacokinetic properties for real-time surgical guidance," the authors write.