First-in-man study of the PSMA Minibody IR800-IAB2M for molecularly targeted intraoperative fluorescence guidance during radical prostatectomy

Purpose Prostate-specific membrane antigen (PSMA) is increasingly used to image prostate cancer in clinical practice. We sought to develop and test a humanised PSMA minibody IAB2M conjugated to the fluorophore IRDye 800CW-NHS ester in men undergoing robot-assisted laparoscopic radical prostatectomy...

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Vydané v:European journal of nuclear medicine and molecular imaging Ročník 51; číslo 10; s. 3009 - 3025
Hlavní autori: Hamdy, Freddie C., Lamb, Alastair D., Tullis, Iain D. C., Verrill, Clare, Rombach, Ines, Rao, Srinivasa R., Colling, Richard, Barber, Paul R., Volpi, Davide, Barbera-Martin, Luis, Lopez, J Francisco, Omer, Altan, Hewitt, Aimi, Lovell, Shelagh, Niederer, Jane, Lambert, Adam, Snoeck, Joke, Thomson, Claire, Leslie, Tom, Bryant, Richard J., Mascioni, Alessandro, Jia, Fang, Torgov, Michael, Wilson, Ian, Gudas, Jean, Wu, Anna M., Olafsen, Tove, Vojnovic, Borivoj
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2024
Springer Nature B.V
Predmet:
Cardiology
Cell culture
Fluorescence
Imaging
In vivo methods and tests
Laparoscopy
Lymph nodes
Lymphatic system
Medical imaging
Medicine
Medicine & Public Health
Nuclear Medicine
Oncology
Original
Original Article
Orthopedics
Prostate cancer
Prostatectomy
Radiology
Reagents
Robotic surgery
Sensitivity analysis
Surgery
White light
Xenotransplantation
Optical imaging
Prostate Cancer
Intraoperative imaging
Fluorescence Molecular Imaging
ISSN:1619-7070, 1619-7089, 1619-7089
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Popis
Shrnutí:Purpose Prostate-specific membrane antigen (PSMA) is increasingly used to image prostate cancer in clinical practice. We sought to develop and test a humanised PSMA minibody IAB2M conjugated to the fluorophore IRDye 800CW-NHS ester in men undergoing robot-assisted laparoscopic radical prostatectomy (RARP) to image prostate cancer cells during surgery. Methods The minibody was evaluated pre-clinically using PSMA positive/negative xenograft models, following which 23 men undergoing RARP between 2018 and 2020 received between 2.5 mg and 20 mg of IR800-IAB2M intravenously, at intervals between 24 h and 17 days prior to surgery. At every step of the procedure, the prostate, pelvic lymph node chains and extra-prostatic surrounding tissue were imaged with a dual Near-infrared (NIR) and white light optical platform for fluorescence in vivo and ex vivo. Histopathological evaluation of intraoperative and postoperative microscopic fluorescence imaging was undertaken for verification. Results Twenty-three patients were evaluated to optimise both the dose of the reagent and the interval between injection and surgery and secure the best possible specificity of fluorescence images. Six cases are presented in detail as exemplars. Overall sensitivity and specificity in detecting non-lymph-node extra-prostatic cancer tissue were 100% and 65%, and 64% and 64% respectively for lymph node positivity. There were no side-effects associated with administration of the reagent. Conclusion Intraoperative imaging of prostate cancer tissue is feasible and safe using IR800-IAB2M. Further evaluation is underway to assess the benefit of using the technique in improving completion of surgical excision during RARP. Registration ISCRCTN10046036: https://www.isrctn.com/ISRCTN10046036 .
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1619-7070
1619-7089
1619-7089
DOI:10.1007/s00259-024-06713-x