Let it glow: Intraoperative visualization of pulmonary metastases using pafolacianine, a next-generation fluorescent agent, for young adults undergoing pulmonary metastasectomy

Pediatr Blood Cancer. 2024 Nov;71(11):e31293. doi: 10.1002/pbc.31293. Epub 2024 Aug 27.

Abstract

A new generation of disease-specific molecular imaging agents is poised to revolutionize fluorescence-guided surgery. Pafolacianine has been approved for adult lung and ovarian cancers. We demonstrate a proof of concept for pediatric surgeons treating young adults with pulmonary metastatic sarcomas. Five successful fluorescence-guided pulmonary metastasectomy operations were performed in young adult patients with metastatic osteosarcoma or Ewing sarcoma following administration of pafolacianine. All osteosarcoma lesions identified using standard techniques were also markedly fluorescent in patients. Novel fluorescent molecular agents targeted to tumor-specific receptors have promise of increased sensitivity and specificity for detecting metastatic nodules and enhancing surgical clearance of disease.

Keywords: fluorescence; pulmonary metastases; thoracoscopic; thoracotomy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / secondary
  • Bone Neoplasms / surgery
  • Female
  • Fluorescent Dyes*
  • Humans
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / secondary
  • Lung Neoplasms* / surgery
  • Male
  • Metastasectomy* / methods
  • Osteosarcoma / diagnostic imaging
  • Osteosarcoma / pathology
  • Osteosarcoma / surgery
  • Sarcoma, Ewing / diagnostic imaging
  • Sarcoma, Ewing / pathology
  • Sarcoma, Ewing / surgery
  • Young Adult

Substances

  • Fluorescent Dyes