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Ann Surg Oncol. 2017 Oct;24(11):3167-3173. doi: 10.1245/s10434-017-5991-3. Epub 2017 Jul 11.

Intraoperative Tumor Detection Using a Ratiometric Activatable Fluorescent Peptide: A First-in-Human Phase 1 Study.

Author information

1
Department of Surgery, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA.
2
Avelas Biosciences, Inc., La Jolla, CA, USA.
3
Department of Surgery, Stanford University, Stanford, CA, USA.
4
Department of Surgery, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA. amwallace@ucsd.edu.

Abstract

BACKGROUND:

Positive surgical margins remain a significant challenge in breast cancer surgery. This report describes the use of a novel, first-in-human ratiometric activatable cell-penetrating peptide in breast cancer surgery.

METHODS:

A two-part, multi-institutional phase 1 trial of AVB-620 with a 3+3 dose escalation and dose-expansion cohorts was conducted. The patients received an infusion of AVB-620 2-20 h before planned lumpectomy/mastectomy and sentinel node biopsy/axillary dissection. Imaging analysis was performed on images obtained from the surgical field as well as post-excision surgical specimens. Pathology reports were obtained to correlate imaging results with histopathologic data. Information on physical adverse events and laboratory abnormalities were recorded.

RESULTS:

A total of 27 patients received infusion of AVB-620 and underwent surgical excision of breast cancer. The findings showed no adverse events or laboratory values attributable to infusion of AVB-620. The 8-mg dose was selected from the dose-escalation cohort for use with the expansion cohort based on imaging data. Region-of-interest (ROI) imaging analysis from the 8-mg cohort demonstrated measurable changes between pathology confirmed tumor-positive and tumor-negative tissue.

CONCLUSION:

Intraoperative imaging of surgical specimens after infusion with AVB-620 allowed for real-time tumor detection. Infusion of AVB-620 is safe and may improve intraoperative detection of malignant tissue during breast cancer operations.

PMID:
28699134
DOI:
10.1245/s10434-017-5991-3
[Indexed for MEDLINE]

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