Recently, a category-leading proof-of-concept study, “Targeted Detection of Cancer at the Cellular Level During Biopsy by Near-Infrared Confocal Laser Endomicroscopy,” was published in Nature Communications.

The study demonstrated the use of On Target’s intraoperative molecular imaging agent, CYTALUX™ (pafolacianine) injection, in conjunction with Mauna Kea’s U.S. FDA 510(k) cleared Cellvizio® platform for the detection of cancer cells during biopsy procedures. The new approach has the potential to help physicians diagnose lung cancer in earlier stages.

DocWire News spoke with Gregory Kennedy, MD, a resident in General Surgery at the University of Pennsylvania, and one of the study’s principal investigators, about the analysis and its implications.

DocWire News: Can you provide us with some professional background on yourself?

Dr. Gregory Kennedy: Sure. I am a resident in general surgery at the University of Pennsylvania, with an interest in thoracic surgery. That’s cancers of the chest, primarily the lungs and the mediastinum as well.

Why is lung cancer hard to detect early on?

Well, I think it can be challenging, especially because these lung cancers present early on as very small nodules in the chest. And so, sometimes even with our advanced screening and imaging modalities, they can be challenging to identify. And then even if we see something on CAT scan that’s concerning for lung cancer, it can be challenging to actually biopsy those lesions. And so, I think the combination of these being very small lesions that could be challenging to see both on CAT scans and then also actually biopsy to determine if it’s a cancer or not, is the primary reason why early stage lung cancer can be a challenge to detect.

Talk to us about the study you co-led that was published in Nature.

Absolutely. We conducted an early-stage feasibility trial of a new technology aimed at being able to detect lung cancer in very small quantities. And this was primarily done in cell and animal models of lung cancer. And what the technology is, is it uses a targeted tracer that actually glows. And so, it will localize to cancer cells because cancer cells over-express certain cell surface receptors, so this glowing molecule localizes the cancer cells. And we give that to the animals before the biopsy procedure. And then, during the biopsy, we actually use a small detector that can actually pick up this glowing signal from the cancer cells. And this detector is so small that it can fit within the middle of the needle that we use to actually take the biopsies.

So, essentially we’re able, using this technology, to detect cellular level quantities of cancer during biopsy. And so, the goal is basically to be able to use this technology as a way of assisting traditional ways of biopsying cancer in order to increase the accuracy in being able to detect cancer earlier. So, as I said, we primarily did this in cell and animal models of lung cancer, but we did test this on human tumors after they’d been taken out of body and were able to show that it works in human tumors as well. So, we’re excited for the possibilities of this work. Ultimately, we need to do this in real patients with their tumors inside of their lungs still, to be able to determine definitively whether it works or not. But we’re excited about the possibilities.

What did you find most exciting about the results?

I think we were excited by the ease of use of this technology. I think a lot of times some of the technologies that we study in the lab are challenging to implement in a clinical setting because they’re not very user friendly. But with this technology, you can take your biopsy. You can stick at this device in the biopsy needle, and you can either see basically one of two things. Either you can see blowing cancer cells, or you can see essentially a blank screen. And so, it’s very easy for surgeons and for radiologists or pulmonologists who are taking these biopsies to actually determine whether or not they have the cancer or not in the biopsy. And so, we’re excited that this may actually have real clinical relevance and may be able to transition this technology into clinical use at a more rapid pace than previous things we’ve developed in the lab that are a little bit more limited from a practical application standpoint.

What are the clinical implications of these findings?

Well, I think the ultimate goal of the work of our lab, generally, is to be able to improve outcomes for patients with lung cancer. And the best way we know how to do that is to be able to detect lung cancer earlier. And so, there are a lot of efforts that have been going on nationally in order to detect lung cancer at an earlier stage, primarily by having patients undergo CAT scans if they’re at high risk for lung cancer. And so, in that way we’re able to pick up a lot of lung cancers earlier. But then, once you pick up these nodules that are suspicious for lung cancer in order to actually determine whether or not it’s cancer or not, you need to biopsy it. And so, that’s really where we come in, is to be able to take these millions of nodules that are detected annually and be able to more accurately tease out which ones are cancers or not, and which ones can undergo curative surgery. And so, I think the goal of our efforts in combination with a lot of efforts that are going on around the country is to improve the detection rates and early treatment for patients with lung cancer in order to have an impact on their survival in the long term.