Breast Cancer Awareness: The Need for Advanced Technologies in the Operating Room

While there has been tremendous progress in the development of new cancer therapeutics, there has been much less progress advancing surgical practices that revolutionize care within the operating room.

For decades, surgeons have relied primarily on visual inspection and manual palpation to determine the boundaries between cancerous and noncancerous tissue.  These techniques can be ambiguous and subjective, and results can only be confirmed days or weeks later after removed tissue is examined by a pathologist. This ambiguity presents a dilemma for many surgeons as removing too much healthy tissue can lead to complications, while failing to remove all tumor tissue could necessitate additional surgery.

The Problem: Multiple Surgeries in Breast Cancer Lumpectomies

Initial management of a breast cancer diagnosis typically involves surgery, consisting of a lumpectomy or mastectomy, with lumpectomy representing the majority of procedures performed. Many women who undergo lumpectomy, however, must endure subsequent second and even third surgeries to fully remove tumor tissue. The frequency of these recurrent surgeries varies among treatment centers, but is typically reported at between 20-40 percent.

In addition to increased cost and emotional burden, consequences of a return to the operating room also include a 34 percent increase in infection rates, a delay in starting needed chemotherapy or radiation therapy, an increased rate of local reoccurrence of the primary tumor, and a proportion of women choosing the more radical option of mastectomy for their second operation.

Potential Solution: “Illuminate” the Cancer for Doctors during Surgery

COI company, Avelas Biosciences, is looking to address these issues by developing a real-time “cancer illuminator,” called AVB-620, which is designed to enable surgeons to distinguish tumor from normal tissue during surgery.  The goal is to offer the necessary real-time information needed by surgeons to visualize and excise the cancerous tissue while they operate and avoid the need for additional surgeries.

AVB-620 is a fluorescent, cancer-illuminating probe that “lights up” when it interacts with cancer cells and is designed to aid cancer surgeons in distinguishing between tumor and healthy tissue during surgery.  Avelas has completed a phase 1b trial for AVB-620 and found that intraoperative imaging of surgical specimens after infusion with AVB-620 allowed for tumor detection. Additionally, no drug-related adverse events were noted in the trial and AVB-620..

A phase 2 study of AVB-620 evaluating 100 patients is ongoing and will assess the accuracy of AVB-620 imaging to distinguish between malignant and nonmalignant tissues.

The pioneering technology behind AVB-620 was developed at UC San Diego in the laboratory Dr. Roger Y. Tsien, who received the 2008 Nobel Prize in Chemistry for his work on fluorescent proteins.

Find out more about Avelas and their clinical trial in the links below:

Annals of Surgical Oncology: First-in-Human Phase 1 Study
Theranostics: AVB-620 Shows Sensitive In Vivo Visualization of Breast Cancer
Avelas Biosciences Company Website