Project 1: Clinical Trials in Intraoperative Molecular Imaging of Non-Small Cell Cancer

项目摘要 本项目的主要目标是将近红外光学造影剂用于图像引导成像 支气管镜检查和手术当发现病人有肺结节时，这两种程序是一种 诊断性支气管镜检查和治疗性手术。然而，这两个程序都受到 诸如区分癌性和非癌性结节、寻找第二个结节、 癌症，识别阳性边缘，并进行准确的后台病理评估。 因此，支气管镜检查和肺癌手术的成功率都在60%左右。那里 迫切需要开发新的创新技术，以帮助临床医生 定位癌细胞，描绘肿瘤边缘，识别微转移和引流淋巴 结我们提出了一种新的技术，在标准护理支气管镜检查期间对患者进行成像， 手术，以确定癌性病变，以发现残留的局部疾病，然后完成 程序，并作出诊断。虽然所提出的技术广泛适用于固体 该项目专门致力于改善肺癌的检测，这是世界上最重要的癌症之一。 侵袭性人类恶性肿瘤为了实现这一目标，我们组建了一个合作团队， 宾夕法尼亚大学，在临床试验、肺病理学、胸外科、 和成像。拟议的工作将优化四种不同类型的造影剂的组合或 用于平移术中成像临床试验的鸡尾酒。将对示踪剂组合进行评价 在肺癌患者的首次人体临床试验中， 术中成像到标准护理支气管镜检查和手术。组合造影剂 该策略将允许更好地对深埋在组织中的病变细胞进行成像。这将允许 精确的肿瘤定位和更准确的癌症切除，而不破坏肿瘤包膜 或者在体腔内播种

Project Summary The primary goal of this Project is to translate near-infrared optical contrast agents for image-guided bronchoscopy and surgery. When a patient is found to have a lung nodule, the two procedures are a diagnostic bronchoscopy and a therapeutic surgery. However, these two procedures are plagued with problems such as discriminating between cancerous and non-cancerous nodules, finding second cancers, identifying positive margins, and performing an accurate back table pathological assessment. Therefore, the success rate for bronchoscopy and surgery for lung cancer are both around 60%. There are urgent unmet needs to develop new and innovative technologies that can assist the clinician in localizing cancer cells, delineating tumor margins, and identifying micrometastases and draining lymph nodes. We propose a new technology to image patients during standard-of-care bronchoscopy and surgery in order to identify cancerous lesions, to discover residual local disease before completing the procedure, and to render a diagnosis. While the proposed technologies are broadly applicable to solid tumors, this project is specifically committed to improving detection of lung cancer, one of the most aggressive human malignancies. To accomplish this goal, we have assembled a collaborative team at University of Pennsylvania with synergistic expertise in clinical trials, lung pathology, thoracic surgery, and imaging. The proposed work will optimize four distinct types of contrast agents in a combination or cocktail for a translational intraoperative imaging clinical trials. The tracer combination will be evaluated in a first-in-human clinical trial of lung cancer patients in order to determine if there is a benefit of intraoperative imaging to standard-of-care bronchoscopy and surgery. The combination contrast agent strategy will allow better imaging of diseased cells more deeply buried in the tissues. This will allow for precise tumor localization and more accurate resection of cancers without violating the tumor capsule or seeding the body cavity.