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STS 2020: Intraoperative Molecular Imaging During Surgery for NSCLC

By: Sarah Campen, PharmD
Posted: Thursday, January 30, 2020

A novel tumor-highlighting technology—OTL38—may allow surgeons to identify the precise location of tumor tissue during thoracic surgery in patients with suspicious lesions, improving outcomes in many patients. The results of the phase II study were presented during the Plenary Session at the 2020 Society of Thoracic Surgeons (STS) Annual Meeting in New Orleans. Moving forward, a phase III clinical trial of this imaging technique is underway.

“OTL38 is the first technique that is specific to imaging adenocarcinomas of the lung, making it unique and clinically useful in this respect,” stated Inderpal S. Sarkaria, MD, of the University of Pittsburgh Medical Center, in an STS press release. “Localization of tumors, identification of occult tumors, and immediate tumor margin assessment during surgery for adenocarcinomas of the lung were significantly improved with the use of this technology.”

OTL38 is a near-infrared, folate-receptor targeted agent that can be illuminated intraoperatively using a special surgical endoscope. A total of 92 patients with suspicious lung lesions received OTL38 at 0.025 mg/kg prior to surgery. The researchers made assessments in three phases: lung inspection, tumor resection, and specimen check.

During the inspection phase, additional lesions were found in 2 patients using standard-of-care visual inspection and manual palpation alone, whereas 10 additional lesions were found in 7 patients by molecular imaging. In the resection phase, OTL38 enabled localization of lesions that were not found in 11 patients (12%). After surgeons found that all margins were visually clear in the specimen check, molecular imaging revealed inadequate margins in eight patients.

Overall, intraoperative molecular imaging improved outcomes in 26% of patients. The benefits of OTL38 were reported to be most substantial in patients undergoing sublobar pulmonary resection and in those with ground-glass opacities. No drug-related serious adverse events were reported.

Disclosure: The study authors’ disclosure information can be found at sts.org.



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