1
|
Jeremiasse B, Rijs Z, Angoelal KR, Hiemcke-Jiwa LS, de Boed EA, Kuppen PJK, Sier CFM, van Driel PBAA, van de Sande MAJ, Wijnen MHWA, Rios AC, van der Steeg AFW. Evaluation of Potential Targets for Fluorescence-Guided Surgery in Pediatric Ewing Sarcoma: A Preclinical Proof-of-Concept Study. Cancers (Basel) 2023; 15:3896. [PMID: 37568714 PMCID: PMC10417270 DOI: 10.3390/cancers15153896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Fluorescence-guided surgery (FGS), based on fluorescent tracers binding to tumor-specific biomarkers, could assist surgeons to achieve complete tumor resections. This study evaluated potential biomarkers for FGS in pediatric Ewing sarcoma (ES). Immunohistochemistry (IHC) was performed to assess CD99, CXCR4, CD117, NPY-R-Y1, and IGF-1R expression in ES biopsies and resection specimens. LINGO-1 and GD2 evaluation did not work on the acquired tissue. Based on the immunoreactive scores, anti-CD99 and anti-CD117 were evaluated for binding specificity using flow cytometry and immunofluorescence microscopy. Anti-GD2, a tracer in the developmental phase, was also tested. These three tracers were topically applied to a freshly resected ES tumor and adjacent healthy tissue. IHC demonstrated moderate/strong CD99 and CD117 expression in ES tumor samples, while adjacent healthy tissue had limited expression. Flow cytometry and immunofluorescence microscopy confirmed high CD99 expression, along with low/moderate CD117 and low GD2 expression, in ES cell lines. Topical anti-CD99 and anti-GD2 application on ES tumor showed fluorescence, while anti-CD117 did not show fluorescence for this patient. In conclusion, CD99-targeting tracers hold promise for FGS of ES. CD117 and GD2 tracers could be potential alternatives. The next step towards development of ES-specific FGS tracers could be ex vivo topical application experiments on a large cohort of ES patients.
Collapse
Affiliation(s)
- Bernadette Jeremiasse
- Department of Surgery, Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (B.J.); (K.R.A.); (M.A.J.v.d.S.); (M.H.W.A.W.); (A.F.W.v.d.S.)
| | - Zeger Rijs
- Department of Orthopedic Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Karieshma R. Angoelal
- Department of Surgery, Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (B.J.); (K.R.A.); (M.A.J.v.d.S.); (M.H.W.A.W.); (A.F.W.v.d.S.)
| | - Laura S. Hiemcke-Jiwa
- Department of Pathology, Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (L.S.H.-J.); (E.A.d.B.)
- Department of Pathology, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Ella A. de Boed
- Department of Pathology, Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (L.S.H.-J.); (E.A.d.B.)
| | - Peter J. K. Kuppen
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (P.J.K.K.); (C.F.M.S.)
| | - Cornelis F. M. Sier
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (P.J.K.K.); (C.F.M.S.)
| | | | - Michiel A. J. van de Sande
- Department of Surgery, Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (B.J.); (K.R.A.); (M.A.J.v.d.S.); (M.H.W.A.W.); (A.F.W.v.d.S.)
- Department of Orthopedic Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Marc H. W. A. Wijnen
- Department of Surgery, Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (B.J.); (K.R.A.); (M.A.J.v.d.S.); (M.H.W.A.W.); (A.F.W.v.d.S.)
| | - Anne C. Rios
- Research Department, Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands;
- Oncode Institute, Jaarbeursplein 6, 3521 AL Utrecht, The Netherlands
| | - Alida F. W. van der Steeg
- Department of Surgery, Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (B.J.); (K.R.A.); (M.A.J.v.d.S.); (M.H.W.A.W.); (A.F.W.v.d.S.)
| |
Collapse
|
2
|
Rijs Z, Belt E, Kalisvaart GM, Sier CFM, Kuppen PJK, Cleven AHG, Vahrmeijer AL, van de Sande MAJ, van Driel PBAA. Immunohistochemical Evaluation of Candidate Biomarkers for Fluorescence-Guided Surgery of Myxofibrosarcoma Using an Objective Scoring Method. Biomedicines 2023; 11:biomedicines11030982. [PMID: 36979961 PMCID: PMC10046284 DOI: 10.3390/biomedicines11030982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/22/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Myxofibrosarcoma (MFS) is the most common soft-tissue sarcoma subtype in elderly patients. Local recurrence (LR) remains a major concern as the lack of intraoperative guidance and an infiltrative growth pattern with long, slender tails hamper surgeons' ability to achieve adequate resection margins for MFS. Fluorescence-guided surgery (FGS) could overcome this concern by delineating tumor tissue during surgery. One of the most important steps to successful FGS is to define a tumor-specific biomarker that is highly overexpressed in tumor tissue while low or absent in adjacent healthy tissue. The aim of this study is to evaluate the expression of eight previously selected promising biomarkers for FGS in MFS tissue samples with adjacent healthy tissue using immunohistochemistry (IHC). METHODS The following eight biomarkers were stained in seventeen paraffin-embedded MFS samples: tumor endothelial marker-1 (TEM-1, also known as endosialin/CD248), vascular endothelial growth factor receptor-1 (VEGFR-1, also known as Flt-1), vascular endothelial growth factor receptor-2 (VEGFR-2, also known as Flk1), vascular endothelial growth factor-A (VEGF-A), epidermal growth factor receptor (EGFR), insulin-like growth factor-1 receptor (IGF-1R), platelet derived growth factor receptor-α (PDGFR-α), and cluster of differentiation 40 (CD40, also known as TNFRSF5). A pathologist specializing in sarcoma annotated the margin between the tumor and adjacent healthy tissue in each MFS tissue sample. Subsequently, we used an objective IHC scoring method to assess and compare the difference in staining intensity between the tumor and adjacent healthy tissue, which is crucial for the use of FGS. RESULTS TEM-1, VEGF-A, and PDGFR-α stained all MFS tumors, while the other biomarkers did not show expression in all MFS tumors. Ultimately, TEM-1 was identified as the most suitable biomarker for FGS in MFS based on higher tumor-to-background (TBR) staining intensity compared to VEGF-A and PDGFR-α, regardless of preoperative therapy. CONCLUSION TEM-1-targeted FGS tracers should be further investigated to optimize MFS treatment.
Collapse
Affiliation(s)
- Zeger Rijs
- Department of Orthopedic Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Esther Belt
- Department of Orthopedic Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Gijsbert M Kalisvaart
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Cornelis F M Sier
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Percuros BV, Zernikedreef 8, 2333 CL Leiden, The Netherlands
| | - Peter J K Kuppen
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Arjen H G Cleven
- Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Pathology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Alexander L Vahrmeijer
- Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Michiel A J van de Sande
- Department of Orthopedic Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | | |
Collapse
|
3
|
Gacaferi H, Geurkink TH, van Adrichem RA, van Driel PBAA, Vermeulen HEM, Nagels J. [Frozen shoulder: A long-lasting and misunderstood clinical problem]. Ned Tijdschr Geneeskd 2022; 166:D6191. [PMID: 35499597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Frozen shoulder (FS), also known as adhesive capsulitis, is a painful inflammatory fibrotic disease of the glenohumeral joint capsule. While it's frequently self-limiting, patients can be symptomatic for years. The clinical course is often divided into three phases: the freezing phase with predominantly pain, the frozen phase with mainly stiffness, and the thawing phase during which the complaints slowly resolve. Diagnosing FS can be challenging during the freezing phase as the symptoms in this phase are similar to other common shoulder conditions (such as subacromial pain syndrome). Treatment options include analgesia, physical therapy, corticosteroid injections, hydrodilatation, manipulation under anaesthesia, and arthroscopic release. Despite the many treatment options, there is no clear treatment guideline. Based on recent literature, conservative management is indicated as it can provide temporary symptom reduction. Due to significant risk of complications, surgical management should only be considered if patients retain complaints despite long-term conservative therapy.
Collapse
Affiliation(s)
- Hamez Gacaferi
- LUMC, afd. Orthopedie, Leiden and University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom
- Contact: Hamez Gacaferi
| | | | | | | | | | | |
Collapse
|
4
|
van Schie P, van der Lelij TJN, Gerritsen M, Meijer RPJ, van Arkel ERA, Fiocco M, Swen JWA, Vahrmeijer AL, Hazelbag HM, Keereweer S, van Driel PBAA. Intra-operative assessment of the vascularisation of a cross section of the meniscus using near-infrared fluorescence imaging. Knee Surg Sports Traumatol Arthrosc 2022; 30:1629-1638. [PMID: 34347140 PMCID: PMC9033697 DOI: 10.1007/s00167-021-06690-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/28/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to assess whether the vascularisation of the meniscus could be visualised intra-operatively using near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) in patients undergoing total knee arthroplasty (TKA). METHODS The anterior horn (i.e., Cooper classification: zones C and D) of the meniscus that was least affected (i.e., least degenerative) was removed during TKA surgery in ten patients to obtain a cross section of the inside of the meniscus. Thereafter, 10 mg of ICG was injected intravenously, and vascularisation of the cross section of the meniscus was assessed using the Quest spectrum NIRF camera system. We calculated the percentage of patients in whom vascularisation was observed intra-operatively using NIRF imaging compared to immunohistochemistry. RESULTS Meniscal vascularisation using NIRF imaging was observed in six out of eight (75%) patients in whom vascularisation was demonstrated with immunohistochemistry. The median extent of vascularisation was 13% (interquartile range (IQR) 3-28%) using NIRF imaging and 15% (IQR 11-23%) using immunohistochemistry. CONCLUSION This study shows the potential of NIRF imaging to visualise vascularisation of the meniscus, as vascularisation was observed in six out of eight patients with histologically proven meniscal vascularisation. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Peter van Schie
- Department of Orthopaedic Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
| | - Thies J. N. van der Lelij
- grid.10419.3d0000000089452978Department of Orthopaedic Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Maxime Gerritsen
- grid.10419.3d0000000089452978Department of Orthopaedic Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Ruben P. J. Meijer
- grid.10419.3d0000000089452978Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands ,grid.418011.d0000 0004 0646 7664Centre for Human Drug Research, Leiden, The Netherlands
| | - Ewoud R. A. van Arkel
- grid.414842.f0000 0004 0395 6796Department of Orthopaedic Surgery, Haaglanden Medical Centre, The Hague, The Netherlands
| | - Marta Fiocco
- grid.5132.50000 0001 2312 1970Mathematical Institute Leiden University, Leiden, The Netherlands ,grid.10419.3d0000000089452978Department of Biomedical Data Science, Medical Statistics Section, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jan-Willem A. Swen
- grid.414842.f0000 0004 0395 6796Department of Orthopaedic Surgery, Haaglanden Medical Centre, The Hague, The Netherlands
| | - Alexander L. Vahrmeijer
- grid.10419.3d0000000089452978Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Hans Marten Hazelbag
- grid.414842.f0000 0004 0395 6796Department of Pathology, Haaglanden Medical Centre, The Hague, The Netherlands
| | - Stijn Keereweer
- grid.5645.2000000040459992XDepartment of Otorhinolaryngology Head and Neck Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Pieter B. A. A. van Driel
- grid.452600.50000 0001 0547 5927Department of Orthopaedic Surgery, Isala Medical Centre, Zwolle, The Netherlands
| |
Collapse
|
5
|
van Driel PBAA, Keereweer S, Lowik CWGM, Oliveira S. Investigation of the Therapeutic Potential of Nanobody-Targeted Photodynamic Therapy in an Orthotopic Head and Neck Cancer Model. Methods Mol Biol 2022; 2451:521-531. [PMID: 35505029 DOI: 10.1007/978-1-0716-2099-1_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Photodynamic therapy (PDT) has a great therapeutic potential because it induces local cellular cytotoxicity upon application of a laser light that excites a photosensitizer, leading to toxic reactive oxygen species. Nevertheless, PDT still is underutilized in the clinic, mostly because of damage induced to normal surrounding tissues. Efforts have been made to improve the specificity. Nanobody-targeted PDT is one of such approaches, in which the variable domain of heavy-chain antibodies, i.e., nanobodies, are used to target photosensitizers selectively to cancer cells. In vitro studies are certainly very valuable to evaluate the therapeutic potential of PDT approaches, but many aspects such as bio-distribution of the photosensitizers, penetration through tissues, and clearance are not taken into account. In vivo studies are therefore essential to assess the influence of such factors, in order to gain more insights into the therapeutic potential of a treatment under development. This chapter describes the development of an orthotopic model of head and neck cancer, to which nanobody-targeted PDT is applied, and the therapeutic potential is assessed by immunohistochemistry one day after PDT.
Collapse
Affiliation(s)
- Pieter B A A van Driel
- Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Stijn Keereweer
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Clemens W G M Lowik
- Department of Radiology & Nuclear Medicine, Optical Molecular Imaging, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sabrina Oliveira
- Cell Biology, Neurobiology and Biophysics, Department of Biology, Faculty of Science, Utrecht University, Utrecht, The Netherlands.
- Pharmaceutics, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands.
| |
Collapse
|
6
|
Lauwerends LJ, van Driel PBAA, Koljenović S, Vahrmeijer AL, Keereweer S. Real-time fluorescence imaging for cancer surgery: a pathologist's perspective - Authors' reply. Lancet Oncol 2021; 22:e283. [PMID: 34197746 DOI: 10.1016/s1470-2045(21)00335-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Lorraine J Lauwerends
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Senada Koljenović
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Stijn Keereweer
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands.
| |
Collapse
|
7
|
Lauwerends LJ, van Driel PBAA, Baatenburg de Jong RJ, Hardillo JAU, Koljenovic S, Puppels G, Mezzanotte L, Löwik CWGM, Rosenthal EL, Vahrmeijer AL, Keereweer S. Real-time fluorescence imaging in intraoperative decision making for cancer surgery. Lancet Oncol 2021; 22:e186-e195. [PMID: 33765422 DOI: 10.1016/s1470-2045(20)30600-8] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 02/06/2023]
Abstract
Fluorescence-guided surgery is an intraoperative optical imaging method that provides surgeons with real-time guidance for the delineation of tumours. Currently, in phase 1 and 2 clinical trials, evaluation of fluorescence-guided surgery is primarily focused on its diagnostic performance, although the corresponding outcome variables do not inform about the added clinical benefit of fluorescence-guided surgery and are challenging to assess objectively. Nonetheless, the effect of fluorescence-guided surgery on intraoperative decision making is the most objective outcome measurement to assess the clinical value of this imaging method. In this Review, we explore the study designs of existing trials of fluorescence-guided surgery that allow us to extract information on potential changes in intraoperative decision making, such as additional or more conservative resections. On the basis of this analysis, we offer recommendations on how to report changes in intraoperative decision making that result from fluorescence imaging, which is of utmost importance for the widespread clinical implementation of fluorescence-guided surgery.
Collapse
Affiliation(s)
- Lorraine J Lauwerends
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - José A U Hardillo
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Senada Koljenovic
- Department of Pathology, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Gerwin Puppels
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Laura Mezzanotte
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Clemens W G M Löwik
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Oncology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland; Ludwig Institute for Cancer Research, Lausanne, Switzerland
| | - Eben L Rosenthal
- Department of Otolaryngology, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Stijn Keereweer
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands.
| |
Collapse
|
8
|
de Bruijn HS, Mashayekhi V, Schreurs TJL, van Driel PBAA, Strijkers GJ, van Diest PJ, Lowik CWGM, Seynhaeve ALB, Hagen TLMT, Prompers JJ, Henegouwen PMPVBE, Robinson DJ, Oliveira S. Acute cellular and vascular responses to photodynamic therapy using EGFR-targeted nanobody-photosensitizer conjugates studied with intravital optical imaging and magnetic resonance imaging. Theranostics 2020; 10:2436-2452. [PMID: 32089747 PMCID: PMC7019176 DOI: 10.7150/thno.37949] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/30/2019] [Indexed: 01/10/2023] Open
Abstract
Targeted photodynamic therapy (PDT) has the potential to selectively damage tumor tissue and to increase tumor vessel permeability. Here we characterize the tissue biodistribution of two EGFR-targeted nanobody-photosensitizer conjugates (NB-PS), the monovalent 7D12-PS and the biparatopic 7D12-9G8-PS. In addition, we report on the local and acute phototoxic effects triggered by illumination of these NB-PS which have previously shown to lead to extensive tumor damage. Methods: Intravital microscopy and the skin-fold chamber model, containing OSC-19-luc2-cGFP tumors, were used to investigate: a) the fluorescence kinetics and distribution, b) the vascular response and c) the induction of necrosis after illumination at 1 or 24 h post administration of 7D12-PS and 7D12-9G8-PS. In addition, dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) of a solid tumor model was used to investigate the microvascular status 2 h after 7D12-PS mediated PDT. Results: Image analysis showed significant tumor colocalization for both NB-PS which was higher for 7D12-9G8-PS. Intravital imaging showed clear tumor cell membrane localization 1 and 2 h after administration of 7D12-9G8-PS, and fluorescence in or close to endothelial cells in normal tissue for both NB-PS. PDT lead to vasoconstriction and leakage of tumor and normal tissue vessels in the skin-fold chamber model. DCE-MRI confirmed the reduction of tumor perfusion after 7D12-PS mediated PDT. PDT induced extensive tumor necrosis and moderate normal tissue damage, which was similar for both NB-PS conjugates. This was significantly reduced when illumination was performed at 24 h compared to 1 h after administration. Discussion: Although differences were observed in distribution of the two NB-PS conjugates, both led to similar necrosis. Clearly, the response to PDT using NB-PS conjugates is the result of a complex mixture of tumor cell responses and vascular effects, which is likely to be necessary for a maximally effective treatment.
Collapse
Affiliation(s)
- Henriette S de Bruijn
- Center for Optical Diagnostics and Therapy, Dept. of Otolaryngology and Head & Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Vida Mashayekhi
- Cell Biology Division, Dept. of Biology, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Tom J L Schreurs
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Pieter B A A van Driel
- Division of Optical Molecular Imaging, Dept. of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gustav J Strijkers
- Amsterdam University Medical Centers, University of Amsterdam, Dept. of Biomedical Engineering and Physics, The Netherlands
| | - Paul J van Diest
- Dept. of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Clemens W G M Lowik
- Division of Optical Molecular Imaging, Dept. of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ann L B Seynhaeve
- Laboratory of Experimental Oncology, Dept. of Pathology, Erasmus MC, Rotterdam, The Netherlands
| | - Timo L M Ten Hagen
- Laboratory of Experimental Oncology, Dept. of Pathology, Erasmus MC, Rotterdam, The Netherlands
| | - Jeanine J Prompers
- Biomedical NMR, Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | | | - Dominic J Robinson
- Center for Optical Diagnostics and Therapy, Dept. of Otolaryngology and Head & Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Sabrina Oliveira
- Cell Biology Division, Dept. of Biology, Faculty of Science, Utrecht University, Utrecht, The Netherlands
- Pharmaceutics Division, Dept. of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
9
|
Slooter MD, Handgraaf HJM, Boonstra MC, van der Velden LA, Bhairosingh SS, Que I, de Haan LM, Keereweer S, van Driel PBAA, Chan A, Kobayashi H, Vahrmeijer AL, Löwik CWGM. Detecting tumour-positive resection margins after oral cancer surgery by spraying a fluorescent tracer activated by gamma-glutamyltranspeptidase. Oral Oncol 2018; 78:1-7. [PMID: 29496035 DOI: 10.1016/j.oraloncology.2017.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 12/05/2017] [Accepted: 12/09/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Tumour-positive resection margins are a major problem during oral cancer surgery. gGlu-HMRG is a tracer that becomes fluorescent upon activation by gamma-glutamyltranspeptidase (GGT). This study aims to investigate the combination of gGlu-HMRG and a clinical fluorescence imaging system for the detection of tumour-positive resection margins. MATERIALS AND METHODS The preclinical Maestro and clinical Artemis imaging systems were compared in vitro and ex vivo with cultured human head and neck cancer cells (OSC19, GGT-positive; and FaDu, GGT negative) and tumour-bearing nude mice. Subsequently, frozen sections of normal and oral cancer tissues were ex vivo sprayed with gGlu-HMRG to determine the sensitivity and specificity. Finally, resection margins of patients with suspected oral cancer were ex vivo sprayed with gGlu-HMRG to detect tumour-positive resection margins. RESULTS Both systems could be used to detect gGlu-HMRG activation in vitro and ex vivo in GGT positive cancer cells. Sensitivity and specificity of gGlu-HMRG and the Artemis on frozen tissue samples was 80% and 87%, respectively. Seven patients undergoing surgery for suspected oral cancer were included. In three patients fluorescence was observed at the resection margin. Those margins were either tumour-positive or within 1 mm of tumour. The margins of the other patients were clear (≥8 mm). CONCLUSION This study demonstrates the feasibility to detect tumour-positive resection margins with gGlu-HMRG and a clinical fluorescence imaging system. Applying this technique would enable intraoperative screening of the entire resection margin and allow direct re-resection in case of tumour-positivity.
Collapse
Affiliation(s)
- Maxime D Slooter
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
| | | | - Martin C Boonstra
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Lily-Ann van der Velden
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Head and Neck Oncology and Surgery, Antoni van Leeuwenhoek - Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Ivo Que
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lorraine M de Haan
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Stijn Keereweer
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Pieter B A A van Driel
- Optical Molecular Imaging, Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Alan Chan
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Percuros B.V., Enschede, The Netherlands
| | - Hisataka Kobayashi
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, USA
| | | | - Clemens W G M Löwik
- Optical Molecular Imaging, Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
10
|
Xie B, Stammes MA, van Driel PBAA, Cruz LJ, Knol-Blankevoort VT, Löwik MAM, Mezzanotte L, Que I, Chan A, van den Wijngaard JPHM, Siebes M, Gottschalk S, Razansky D, Ntziachristos V, Keereweer S, Horobin RW, Hoehn M, Kaijzel EL, van Beek ER, Snoeks TJA, Löwik CWGM. Necrosis avid near infrared fluorescent cyanines for imaging cell death and their use to monitor therapeutic efficacy in mouse tumor models. Oncotarget 2016; 6:39036-49. [PMID: 26472022 PMCID: PMC4770755 DOI: 10.18632/oncotarget.5498] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/30/2015] [Indexed: 01/25/2023] Open
Abstract
Quantification of tumor necrosis in cancer patients is of diagnostic value as the amount of necrosis is correlated with disease prognosis and it could also be used to predict early efficacy of anti-cancer treatments. In the present study, we identified two near infrared fluorescent (NIRF) carboxylated cyanines, HQ5 and IRDye 800CW (800CW), which possess strong necrosis avidity. In vitro studies showed that both dyes selectively bind to cytoplasmic proteins of dead cells that have lost membrane integrity. Affinity for cytoplasmic proteins was confirmed using quantitative structure activity relations modeling. In vivo results, using NIRF and optoacoustic imaging, confirmed the necrosis avid properties of HQ5 and 800CW in a mouse 4T1 breast cancer tumor model of spontaneous necrosis. Finally, in a mouse EL4 lymphoma tumor model, already 24 h post chemotherapy, a significant increase in 800CW fluorescence intensity was observed in treated compared to untreated tumors. In conclusion, we show, for the first time, that the NIRF carboxylated cyanines HQ5 and 800CW possess strong necrosis avid properties in vitro and in vivo. When translated to the clinic, these dyes may be used for diagnostic or prognostic purposes and for monitoring in vivo tumor response early after the start of treatment.
Collapse
Affiliation(s)
- Bangwen Xie
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marieke A Stammes
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Percuros BV, Enschede, The Netherlands.,In-vivo-NMR Laboratory, Max Planck Institute for Neurological Research, Cologne, Germany
| | - Pieter B A A van Driel
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Percuros BV, Enschede, The Netherlands
| | - Luis J Cruz
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vicky T Knol-Blankevoort
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Percuros BV, Enschede, The Netherlands
| | - Martijn A M Löwik
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Laura Mezzanotte
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ivo Que
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Alan Chan
- Percuros BV, Enschede, The Netherlands
| | - Jeroen P H M van den Wijngaard
- Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Maria Siebes
- Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sven Gottschalk
- Faculty of Medicine, Technical University of Munich, Munich, Germany.,Institute for Biological and Medical Imaging, Helmholtz Center Munich, Munich, Germany
| | - Daniel Razansky
- Faculty of Medicine, Technical University of Munich, Munich, Germany.,Institute for Biological and Medical Imaging, Helmholtz Center Munich, Munich, Germany
| | - Vasilis Ntziachristos
- Faculty of Medicine, Technical University of Munich, Munich, Germany.,Institute for Biological and Medical Imaging, Helmholtz Center Munich, Munich, Germany
| | - Stijn Keereweer
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Richard W Horobin
- School of Life Sciences, College of Medical, Veterinary and Life Sciences, The University of Glasgow, Glasgow, Scotland, UK
| | - Mathias Hoehn
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Percuros BV, Enschede, The Netherlands.,In-vivo-NMR Laboratory, Max Planck Institute for Neurological Research, Cologne, Germany
| | - Eric L Kaijzel
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ermond R van Beek
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Medres, Cologne, Germany
| | - Thomas J A Snoeks
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Clemens W G M Löwik
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
11
|
van Driel PBAA, Boonstra MC, Slooter MD, Heukers R, Stammes MA, Snoeks TJA, de Bruijn HS, van Diest PJ, Vahrmeijer AL, van Bergen En Henegouwen PMP, van de Velde CJH, Löwik CWGM, Robinson DJ, Oliveira S. EGFR targeted nanobody-photosensitizer conjugates for photodynamic therapy in a pre-clinical model of head and neck cancer. J Control Release 2016; 229:93-105. [PMID: 26988602 PMCID: PMC7116242 DOI: 10.1016/j.jconrel.2016.03.014] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/07/2016] [Accepted: 03/09/2016] [Indexed: 12/21/2022]
Abstract
Photodynamic therapy (PDT) induces cell death through local light activation of a photosensitizer (PS) and has been used to treat head and neck cancers. Yet, common PS lack tumor specificity, which leads to collateral damage to normal tissues. Targeted delivery of PS via antibodies has pre-clinically improved tumor selectivity. However, antibodies have long half-lives and relatively poor tissue penetration, which could limit therapeutic efficacy and lead to long photosensitivity. Here, in this feasibility study, we evaluate at the pre-clinical level a recently introduced format of targeted PDT, which employs nanobodies as targeting agents and a water-soluble PS (IRDye700DX) that is traceable through optical imaging. In vitro, the PS solely binds to cells and induces phototoxicity on cells overexpressing the epidermal growth factor receptor (EGFR), when conjugated to the EGFR targeted nanobodies. To investigate whether this new format of targeted PDT is capable of inducing selective tumor cell death in vivo, PDT was applied on an orthotopic mouse tumor model with illumination at 1h post-injection of the nanobody-PS conjugates, as selected from quantitative fluorescence spectroscopy measurements. In parallel, and as a reference, PDT was applied with an antibody-PS conjugate, with illumination performed 24h post-injection. Importantly, EGFR targeted nanobody-PS conjugates led to extensive tumor necrosis (approx. 90%) and almost no toxicity in healthy tissues, as observed through histology 24h after PDT. Overall, results show that these EGFR targeted nanobody-PS conjugates are selective and able to induce tumor cell death in vivo. Additional studies are now needed to assess the full potential of this approach to improving PDT.
Collapse
Affiliation(s)
- Pieter B A A van Driel
- Department of Radiology, Division of Molecular Imaging, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; Percuros BV, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Martin C Boonstra
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Maxime D Slooter
- Department of Radiology, Division of Molecular Imaging, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; Percuros BV, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Raimond Heukers
- Molecular Oncology, Cell Biology Division, Department of Biology, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH Utrecht, The Netherlands
| | - Marieke A Stammes
- Department of Radiology, Division of Molecular Imaging, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; Percuros BV, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Thomas J A Snoeks
- Department of Radiology, Division of Molecular Imaging, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Henriette S de Bruijn
- Department of Otorhinolaryngology & Head and Neck Surgery, Center for Optical Diagnostics and Therapy, Erasmus Medical Center, s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Alexander L Vahrmeijer
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Paul M P van Bergen En Henegouwen
- Molecular Oncology, Cell Biology Division, Department of Biology, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH Utrecht, The Netherlands
| | - Cornelis J H van de Velde
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Clemens W G M Löwik
- Department of Radiology, Division of Molecular Imaging, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Dominic J Robinson
- Department of Otorhinolaryngology & Head and Neck Surgery, Center for Optical Diagnostics and Therapy, Erasmus Medical Center, s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Sabrina Oliveira
- Molecular Oncology, Cell Biology Division, Department of Biology, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH Utrecht, The Netherlands.
| |
Collapse
|
12
|
van Leeuwen-van Zaane F, Gamm UA, van Driel PBAA, Snoeks TJ, de Bruijn HS, van der Ploeg-van den Heuvel A, Sterenborg HJCM, Löwik CW, Amelink A, Robinson DJ. Intrinsic photosensitizer fluorescence measured using multi-diameter single-fiber spectroscopy in vivo. J Biomed Opt 2014; 19:15010. [PMID: 24477382 DOI: 10.1117/1.jbo.19.1.015010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 12/30/2013] [Indexed: 06/03/2023]
Abstract
Quantification of fluorescence in vivo is complicated by the influence of tissue optical properties on the collected fluorescence signal. When tissue optical properties in the measurement volume are quantified, one can obtain the intrinsic fluorescence, which equals the product of fluorophore absorption coefficient and quantum yield. We applied this method to in vivo single-fiber fluorescence spectroscopy measurements on mouse tongue, skin, liver, and oral squamous cell carcinoma, where we detected intrinsic fluorescence spectra of the photosensitizers chlorin e6 and Bremachlorin at t=[3,4.5,6,24,48] h incubation time. We observed a tissue-dependent maximum of 35% variation in the total correction factor over the visible wavelength range. Significant differences in spectral shape over time between sensitizers were observed. Although the wavelength position of the fluorescence intensity maximum for ce6 shifted to the red, Bremachlorin showed a blue shift. Furthermore, the Bremachlorin peak appeared to be broader than the ce6 fluorescence peak. Intrinsic fluorescence intensity, which can be related to photosensitizer concentration, was decreasing for all time points but showed significantly more Bremachlorin present compared to ce6 at long incubation times. Results from this study can be used to define an optimal treatment protocol for Bremachlorin-based photodynamic therapy.
Collapse
Affiliation(s)
- Floor van Leeuwen-van Zaane
- Postgraduate School Molecular Medicine, Center for Optical Diagnostics and Therapy, Department of Radiation Oncology, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Ute A Gamm
- Postgraduate School Molecular Medicine, Center for Optical Diagnostics and Therapy, Department of Radiation Oncology, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Pieter B A A van Driel
- Leiden University Medical Centre, Department of Radiology, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Thomas J Snoeks
- Leiden University Medical Centre, Department of Radiology, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Henriette S de Bruijn
- Center for Optical Diagnostics and Therapy, Department of Otolaryngology-Head and Neck Surgery, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Angelique van der Ploeg-van den Heuvel
- Center for Optical Diagnostics and Therapy, Department of Otolaryngology-Head and Neck Surgery, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Henricus J C M Sterenborg
- Postgraduate School Molecular Medicine, Center for Optical Diagnostics and Therapy, Department of Radiation Oncology, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Clemens W Löwik
- Leiden University Medical Centre, Department of Radiology, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Arjen Amelink
- Postgraduate School Molecular Medicine, Center for Optical Diagnostics and Therapy, Department of Radiation Oncology, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Dominic J Robinson
- Center for Optical Diagnostics and Therapy, Department of Otolaryngology-Head and Neck Surgery, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| |
Collapse
|
13
|
Keereweer S, Kerrebijn JDF, van Driel PBAA, Xie B, Kaijzel EL, Snoeks TJA, Que I, Hutteman M, van der Vorst JR, Mieog JSD, Vahrmeijer AL, van de Velde CJH, Baatenburg de Jong RJ, Löwik CWGM. Optical image-guided surgery--where do we stand? Mol Imaging Biol 2011; 13:199-207. [PMID: 20617389 PMCID: PMC3051067 DOI: 10.1007/s11307-010-0373-2] [Citation(s) in RCA: 209] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
In cancer surgery, intra-operative assessment of the tumor-free margin, which is critical for the prognosis of the patient, relies on the visual appearance and palpation of the tumor. Optical imaging techniques provide real-time visualization of the tumor, warranting intra-operative image-guided surgery. Within this field, imaging in the near-infrared light spectrum offers two essential advantages: increased tissue penetration of light and an increased signal-to-background-ratio of contrast agents. In this article, we review the various techniques, contrast agents, and camera systems that are currently used for image-guided surgery. Furthermore, we provide an overview of the wide range of molecular contrast agents targeting specific hallmarks of cancer and we describe perspectives on its future use in cancer surgery.
Collapse
Affiliation(s)
- Stijn Keereweer
- Department of Otorhinolaryngology, Head & Neck Surgery, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|