Page 139 - Fluorescence-guided cancer surgery

Imaging FRα positive ovarian and breast cancer 137
the visible light spectrum (500nm). In a limited series of patients undergoing surgery for suspected ovarian cancer, uorescent tumor tissue was observed intraoperatively after intravenous administration of EC17 in 3 out of 4 patients with proven ovarian cancer. However, the intra-operative detection of additional tumor lesions due to the use of EC17 and uorescence imaging was not reported. Moreover, administration of the contrast agents had to be interrupted, although the study could be completed, in several (4 out of 10) patients due to mild adverse events. As a result the initial dose of 0.3 mg/kg was decreased to 0.1 mg/kg, which reduced adverse events while maintaining uorescent signal. To demonstrate the tolerability and additional value of uorescence imaging using EC17 in ovarian cancer, evaluation in a larger patient cohort is required. Although the overexpression of the FRα on selected breast cancer cells has been shown, feasibility of uorescence imaging using EC17 in patients with FRα positive breast cancer has not yet been demonstrated.
Our objective was to evaluate a relatively low dose of EC17 (0.1 mg/kg) in a larger group of ovarian cancer patients and to assess feasibility of intraoperative uorescence imaging in patients with FRα positive breast cancer.
RESULTS
Patient characteristics
A total of 13 ovarian cancer patients were included. Surgery was cancelled in 1 patient due to deterioration of the medical condition of the patient prior to surgery. Thus 12 ovarian cancer patients received EC17 and underwent open surgery; a tabular overview of the patient characteristics, FIGO status and histology of the tumor type is given in Table 1. Six patients underwent a primary cytoreductive procedure, 4 patients an interval cytoreductive procedure and 2 patients a staging procedure.