Jarrod D. Predina, MD, MTR, Andrew D

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Presentation transcript:

A Phase I Clinical Trial of Targeted Intraoperative Molecular Imaging for Pulmonary Adenocarcinomas Jarrod D. Predina, MD, MTR, Andrew D. Newton, MD, Jane Keating, MD, Ashley Dunbar, BA, Courtney Connolly, BA, Michael Baldassari, BA, Jack Mizelle, BA, Leilei Xia, MD, Charuhas Deshpande, MD, John Kucharczuk, MD, Philip S. Low, PhD, Sunil Singhal, MD The Annals of Thoracic Surgery Volume 105, Issue 3, Pages 901-908 (March 2018) DOI: 10.1016/j.athoracsur.2017.08.062 Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Trial workflow. (A) Subjects were infused with OTL38 4 hours before resection. (B) During resection, real-time IMI was performed using a 5-mm thoracoscope. (C) After resection, suspicious nodules were bisected and imaged ex vivo. (D) All specimens were reviewed by a pathologist (microscopy obtained using a 20× objective). The Annals of Thoracic Surgery 2018 105, 901-908DOI: (10.1016/j.athoracsur.2017.08.062) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 OTL38 accumulates in pulmonary adenocarcinoma and generates fluorescence. Representative subjects 14 (upper panels) and 16 (lower panels) displaying in situ fluorescence. Preoperative (A) computed tomography (CT) and (B) positron emission tomography (PET). Intraoperative (C) brightfield and (D) near-infrared (NIR) merge images. Specimens were reviewed by (E) hematoxylin and eosin (H & E) and (F) FRα immunohistochemistry (IHC) (microscopy obtained using a 20× objective). The Annals of Thoracic Surgery 2018 105, 901-908DOI: (10.1016/j.athoracsur.2017.08.062) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Deep tumors display fluorescence upon bisection. In representative subject 2, ex vivo fluorescence after tumor bisection: (A) preoperative computed tomography (CT) demonstrates tumor 1.6 cm from pleural surface; (B) ex vivo near-infrared imaging with no tumor fluorescence (arrow); and (C) ex vivo near-infrared imaging with fluorescence after bisection. The Annals of Thoracic Surgery 2018 105, 901-908DOI: (10.1016/j.athoracsur.2017.08.062) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Intraoperative molecular imaging with OTL38 identifies synchronous nodules in subject 19. A representative nodule is displayed in (A) brightfield and (B) near-infrared (NIR) merge view. (C) The nodule was pulmonary adenocarcinoma by hematoxylin and eosin (H&E), with (D) with FRα expression by immunohistochemistry (IHC) (microscopy obtained using a 20× objective). The Annals of Thoracic Surgery 2018 105, 901-908DOI: (10.1016/j.athoracsur.2017.08.062) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Supplemental Figure 1 The Annals of Thoracic Surgery 2018 105, 901-908DOI: (10.1016/j.athoracsur.2017.08.062) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions