Bright dye helps remove prostate cancer without damaging healthy tissue

Scientists used a fluorescent dye attached to a special marker molecule to give doctors “second pair of eyes” during surgery. Twenty-three men with prostate cancer were given it before surgery to remove their prostate. Marker dye detected areas of cancerous tissue that are undetectable to the naked eye nor with other clinical methods.

The dye allowed surgeons to remove all diseased tissue, which could reduce the chance of cancer returning, and preserve healthy tissue, meaning fewer life-altering side effects after surgery.

The combination of dye and target molecule, called IR800-IAB2M, allows surgeons see the edges of the tumor and identify any groups of cells that have spread from the tumor to nearby pelvic tissues and lymph nodes. This significantly reduces the likelihood of the cancer returning in the future and minimizes the likelihood of life-altering side effects such as incontinence and erectile dysfunction after surgery.

The dye and marker molecule works by binding to a protein called prostate-specific membrane antigen (PSMA), which is commonly found on the surface of prostate cancer cells.

The marker molecule consists of a smaller version of the antibody, called a “minibody,” that can only bind to PSMA and not to any other molecules. The combination of dye and marker molecules was developed by Oxford scientists in collaboration with ImaginAb Inc., a company based in Inglewood, California.

In the first phase of the ProMOTE study, published Monday, 23 men diagnosed with prostate cancer were injected with a fluorescent dye before undergoing robotic surgery to remove the prostate (known as radical prostatectomy). The surgeons used an imaging system that shines a special light on the prostate and surrounding areas, causing prostate cancer cells to glow. The imaging system was developed by a team of engineers led by Professor Borivoj Voinovich from the University of Oxford.

In several patients in the study, the dye revealed clumps of cells that had spread beyond the tumor and were not visible to the naked eye.

This dye marker can be found in your early stages of clinical developmentbut in the future, surgeons will be able to regularly use it to see every part of the cancer during prostate removal surgery.

An imaging system that can see glowing cancer cells could be integrated into robotic instruments used for prostate surgery. It can also be used to treat other types of cancer by changing the protein it uses to attach to malignant cells.

Additional clinical trials are already underway on larger groups of patients to see if this method removes more prostate cancer and preserves more healthy pelvic tissue compared with existing surgical methods.

Prostate cancer is the most common tumor in men. David Butler (77), a former sales development director from Southmoor, Oxfordshire, was one of 23 men who took part in the study. A chance conversation with his family doctor led to a shocking diagnosis of prostate cancer in November 2018. “I literally had no symptoms other than need to urinate faster every time I went to the bathroom. If I hadn’t told my GP, I might not have diagnosed the cancer until it was much more advanced.”

In January 2019, David had his prostate removed along with several lymph nodes and other cancerous tissue using this revolutionary technique. Five years later, he made a full recovery and has been cancer-free since.

“We give the surgeon a second pair of eyes to see where the cancer cells are and whether they have spread. This This is the first time we’ve been able to see such fine details of prostate cancer. in real time during surgery,” says Nuffield, professor of surgery at the University of Oxford and lead author of the study Freddy Hamdy.