Nontoxic Tumor-Targeting Optical Agents for Intraoperative Breast Tumor Imaging

Precise identification of the tumor
margins during breast-conserving
surgery (BCS) remains a challenge given the lack of visual discrepancy
between malignant and surrounding normal tissues. Therefore, we developed
a fluorescent imaging agent, ICG-p28, for intraoperative imaging guidance
to better aid surgeons in achieving negative margins in BCS. Here,
we determined the pharmacokinetics (PK), biodistribution, and preclinical
toxicity of ICG-p28. The PK and biodistribution of ICG-p28 indicated
rapid tissue uptake and localization at tumor lesions. There were
no dose-related effect and no significant toxicity in any of the breast
cancer and normal cell lines tested. Furthermore, ICG-p28 was evaluated
in clinically relevant settings with transgenic mice that spontaneously
developed invasive mammary tumors. Intraoperative imaging with ICG-p28
showed a significant reduction in the tumor recurrence rate. This
simple, nontoxic, and cost-effective method can offer a new approach
that enables surgeons to intraoperatively identify tumor margins and
potentially improves overall outcomes by reducing recurrence rates.