Significance: Surgery is often paramount in the management of many solid organ malignancies because optimal resection is a major factor in disease-specific survival. Cancer surgery has multiple challenges including localizing small lesions, ensuring negative surgical margins around a tumor, adequately staging patients by discriminating positive lymph nodes, and identifying potential synchronous cancers. Intraoperative molecular imaging (IMI) is an emerging potential tool proposed to address these issues. IMI is the process of injecting patients with fluorescent-targeted contrast agents that highlight cancer cells prior to surgery. Over the last 5 to 7 years, enormous progress has been achieved in tracer development, near-infrared camera approvals, and clinical trials. Therefore, a second biennial conference was organized at the University of Pennsylvania to gather surgical oncologists, scientists, and experts to discuss new investigative findings in the field. Our review summarizes the discussions from the conference and highlights findings in various clinical and scientific trials. Aim: Recent advances in IMI were presented, and the importance of each clinical trial for surgical oncology was critically assessed. A major focus was to elaborate on the clinical endpoints that were being utilized in IMI trials to advance the respective surgical subspecialties. Approach: Principal investigators presenting at the Perelman School of Medicine Abramson Cancer Center’s second clinical trials update on IMI were selected to discuss their clinical trials and endpoints. Results: Multiple phase III, II, and I trials were discussed during the conference. Since the approval of 5-ALA for commercial use in neurosurgical malignancies, multiple tracers and devices have been developed to address common challenges faced by cancer surgeons across numerous specialties. Discussants also presented tracers that are being developed for delineation of normal anatomic structures that can serve as an adjunct during surgical procedures. Conclusions: IMI is increasingly being recognized as an improvement to standard oncologic surgical resections and will likely advance the art of cancer surgery in the coming years. The endpoints in each individual surgical subspecialty are varied depending on how IMI helps each specialty solve their clinical challenges.

中文翻译：

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术中分子影像学临床试验：2020 年会议论文集回顾

意义：手术在许多实体器官恶性肿瘤的治疗中通常是最重要的，因为最佳切除是疾病特异性生存的主要因素。癌症手术面临多重挑战，包括定位小病灶、确保肿瘤周围的手术切缘阴性、通过区分阳性淋巴结对患者进行充分分期，以及识别潜在的同步癌症。术中分子成像 (IMI) 是一种新兴的潜在工具，旨在解决这些问题。IMI 是在手术前向患者注射荧光靶向造影剂以突出显示癌细胞的过程。在过去的 5 到 7 年中，示踪剂开发、近红外相机批准和临床试验取得了巨大进展。所以，第二届两年一度的会议在宾夕法尼亚大学举行，聚集外科肿瘤学家、科学家和专家，讨论该领域的新调查结果。我们的评论总结了会议的讨论，并强调了各种临床和科学试验的发现。目的：介绍了 IMI 的最新进展，并严格评估了每项临床试验对外科肿瘤学的重要性。一个主要重点是详细说明 IMI 试验中用于推进各自外科亚专业的临床终点。方法：在佩雷尔曼医学院艾布拉姆森癌症中心介绍 IMI 的第二次临床试验更新的主要研究人员被选中讨论他们的临床试验和终点。结果：多阶段 III、II、和我的试验在会议期间进行了讨论。自从批准 5-ALA 用于神经外科恶性肿瘤的商业用途以来，已经开发了多种示踪剂和设备来解决众多专业的癌症外科医生面临的共同挑战。讨论者还介绍了正在开发的用于描绘正常解剖结构的示踪剂，这些示踪剂可以在外科手术过程中作为辅助手段。结论：IMI 越来越多地被认为是对标准肿瘤外科切除术的改进，并可能在未来几年推动癌症外科手术的发展。每个外科亚专业的终点因 IMI 如何帮助每个专业解决其临床挑战而异。已经开发出多种示踪剂和设备来解决众多专业的癌症外科医生面临的共同挑战。讨论者还介绍了正在开发的用于描绘正常解剖结构的示踪剂，这些示踪剂可以在外科手术过程中作为辅助手段。结论：IMI 越来越多地被认为是对标准肿瘤外科切除术的改进，并可能在未来几年推动癌症外科手术的发展。每个外科亚专业的终点因 IMI 如何帮助每个专业解决其临床挑战而异。已经开发出多种示踪剂和设备来解决众多专业的癌症外科医生面临的共同挑战。讨论者还介绍了正在开发的用于描绘正常解剖结构的示踪剂，这些示踪剂可以在外科手术过程中作为辅助手段。结论：IMI 越来越多地被认为是对标准肿瘤外科切除术的改进，并可能在未来几年推动癌症外科手术的发展。每个外科亚专业的终点因 IMI 如何帮助每个专业解决其临床挑战而异。讨论者还介绍了正在开发的用于描绘正常解剖结构的示踪剂，这些示踪剂可以在外科手术过程中作为辅助手段。结论：IMI 越来越多地被认为是对标准肿瘤外科切除术的改进，并可能在未来几年推动癌症外科手术的发展。每个外科亚专业的终点因 IMI 如何帮助每个专业解决其临床挑战而异。讨论者还介绍了正在开发的用于描绘正常解剖结构的示踪剂，这些示踪剂可以在外科手术过程中作为辅助手段。结论：IMI 越来越多地被认为是对标准肿瘤外科切除术的改进，并可能在未来几年推动癌症外科手术的发展。每个外科亚专业的终点因 IMI 如何帮助每个专业解决其临床挑战而异。