Resecting, or surgically removing, a tumor is a delicate and tricky process. Current methods for getting all the cancer, and sparing normal tissue, is imperfect at best. When a surgeon excises cancerous tissue, it is often evaluated by a pathologist to ensure that the margins are cancer free. If not, it could mean that the patient will need more surgery/radiation, or there is a possibility that the cancer could recur.
In a new study published in Science Translational Medicine, researchers at Duke University Medical Center in Durham, NC have developed an imaging technique that works in what can best be described as the luminol for cancer detection. Luminol, as many of us know, is used by forensic investigators at crime scenes to detect traces of blood. It emits a blue glow as it is oxidized that can be seen in a darkened room.
Similarly, the scientists at Duke in collaboration with the Massachusetts Institute of Technology have created an injectable blue liquid known as LUM015 that acts as a fluorescent probe for imaging cancer cells. Cancer cells secrete more of an enzyme called cathepsin, which allows them to grow and spread (metastasize). LUM015 is activated in the presence of cathepsin, signaling the presence of cancer cells. This was successfully observed in both mouse sarcoma models and a trial involving 15 patients with either soft tissue sarcoma (STS) or breast cancer.
In both the mice and human studies, LUM015 was intravenously injected, and was well-tolerated. Subsequent imaging from the tissue sample revealed a higher degree of fluorescence in cancerous tissue in contrast to normal tissue. The success of this technique has allowed it to advance to Phase II of clinical trials (involving a greater number of patients). Currently at Massachusetts General Hospital, there is a prospective study being carried out involving 50 women with breast cancer.
If this technology is successful in subsequent trials, it would significantly change our treatment of sarcoma," said the study s co-senior author, Dr. Brian Brigman, chief of orthopedic oncology at Duke, as quoted in Medical News Today. "If we can increase the cases where 100 percent of the tumor is removed, we could prevent subsequent operations and potentially cancer recurrence. Knowing where there is residual disease can also guide radiation therapy, or even reduce how much radiation a patient will receive.
The field of chemiluminescence is not necessarily a new idea. But in real-time detection of cancer cells during surgery this could have a significant impact, first and foremost, on the morbidity and mortality of patients. We look forward to and anticipate similar findings in the Phase II trial.