caa a22 4500 445336056 CHVBK 20180317142755.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1245/s10434-010-1524-z doi (NATIONALLICENCE)springer-10.1245/s10434-010-1524-z A Phase 2 Study of 99mTc-Tilmanocept in the Detection of Sentinel Lymph Nodes in Melanoma and Breast Cancer [Elektronische Daten] [Stanley Leong, Julian Kim, Merrick Ross, Mark Faries, Charles Scoggins, Wendy Rich Metz, Frederick Cope, Richard Orahood] Background: Several 99mTc-labeled agents that are not approved by the U.S. Food and Drug Administration are used for lymphatic mapping. A new low-molecular-weight mannose receptor-based, reticuloendothelial cell-directed, 99mTc-labeled lymphatic imaging agent, 99mTc-tilmanocept, was used for lymphatic mapping of sentinel lymph nodes (SLNs) from patients with primary breast cancer or melanoma malignancies. This novel molecular species provides the basis for potentially enhanced SLN mapping reliability. Methods: In a prospectively planned, open-label phase 2 clinical study, 99mTc-tilmanocept was injected into breast cancer and cutaneous melanoma patients before intraoperative lymphatic mapping. Injection technique, preoperative lymphoscintigraphy (LS), and intraoperative lymphatic mapping with a handheld gamma detection probe were performed by investigators per standard practice. Results: Seventy-eight patients underwent 99mTc-tilmanocept injection and were evaluated (47 melanoma, 31 breast cancer). For those whom LS was performed (55 patients, 70.5%), a 99mTc-tilmanocept hot spot was identified in 94.5% of LS patients before surgery. Intraoperatively, 99mTc-tilmanocept identified at least one regional SLN in 75 (96.2%) of 78 patients: 46 (97.9%) of 47 in melanoma and 29 (93.5%) of 31 in breast cancer cases. Tissue specificity of 99mTc-tilmanocept for lymph nodes was 100%, displaying 95.1% mapping sensitivity by localizing in 173 of 182 nodes removed during surgery. The overall proportion of 99mTc-tilmanocept-identified nodes that contained metastatic disease was 13.7%. Five procedure-related serious adverse events occurred, none related to 99mTc-tilmanocept. Conclusions: Our results demonstrate the safety and efficacy of 99mTc-tilmanocept for use in intraoperative lymphatic mapping. The high intraoperative localization and lymph node specificity of 99mTc-tilmanocept and the identification of metastatic disease within the nodes suggest SLNs are effectively identified by this novel mannose receptor-targeted molecule. Society of Surgical Oncology, 2011 Leong Stanley California Pacific Medical Center and Sutter Pacific Medical Foundation and Research Institute, University of California, San Francisco, CA, USA aut Kim Julian University Hospitals Case Medical Center, Cleveland, OH, USA aut Ross Merrick Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, TX, USA aut Faries Mark John Wayne Cancer Institute, Santa Monica, CA, USA aut Scoggins Charles Department of Surgery, University of Louisville, Louisville, KY, USA aut Rich Metz Wendy Department of Clinical Research, Neoprobe Corporation, Dublin, OH, USA aut Cope Frederick Department of Clinical Research, Neoprobe Corporation, Dublin, OH, USA aut Orahood Richard Department of Clinical Research, Neoprobe Corporation, Dublin, OH, USA aut Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 961-969 1068-9265 18:4<961 2011 18 10434 https://doi.org/10.1245/s10434-010-1524-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1524-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Leong Stanley California Pacific Medical Center and Sutter Pacific Medical Foundation and Research Institute, University of California, San Francisco, CA, USA aut NATIONALLICENCE 700 1- Kim Julian University Hospitals Case Medical Center, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Ross Merrick Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Faries Mark John Wayne Cancer Institute, Santa Monica, CA, USA aut NATIONALLICENCE 700 1- Scoggins Charles Department of Surgery, University of Louisville, Louisville, KY, USA aut NATIONALLICENCE 700 1- Rich Metz Wendy Department of Clinical Research, Neoprobe Corporation, Dublin, OH, USA aut NATIONALLICENCE 700 1- Cope Frederick Department of Clinical Research, Neoprobe Corporation, Dublin, OH, USA aut NATIONALLICENCE 700 1- Orahood Richard Department of Clinical Research, Neoprobe Corporation, Dublin, OH, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 961-969 1068-9265 18:4<961 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer