What is image-guided surgery?
The focus of On Target Laboratories is the discovery and development of small molecules that, when conjugated with fluorescent dyes, target and illuminate specific cancerous cells and other diseased tissue. This illumination may provide the surgeon with a clearer view of diseased tissue, creating another decision-making tool to benefit the patient. This technology is based on the pioneering work of Philip S. Low, PhD, the Ralph C. Corley Distinguished Professor of Chemistry at Purdue University and Director of the Purdue University Center for Drug Discovery.
Image-guided surgery is an evolving field in which the surgeon’s ability to identify malignant tissue real-time, utilizing fluorescent probes or imaging agents is aided. If successful, this illumination would enable the identification, staging and removal of diseased tissue and provide more insight for the clinician and, ultimately, the patient.
In the past, a challenge in this field was to develop probes that were targeted and specific to diseased areas without risking healthy tissue. Prior to OTL’s small molecules, many of the available agents lacked the necessary precision.
OTL’s small molecules are very specific to targets overexpressed in diseased tissue, including cancer and autoimmune diseases, and can specifically introduce therapeutics, radio-imaging agents and optical-imaging agents to diseased cells.
Precision engineered with the goal of targeting disease
Currently, surgery is a primary treatment modality for a large number of solid cancers, and published literature shows that for many of these the initial cytoreduction (tumor debulking) has a significant impact on patient outcomes. Surgeons must rely primarily on their visual and tactile senses, aided at times by static pre-operative images, to excise the cancer.
OTL38 is a novel compound consisting of a folic acid-targeting molecule, or ligand, linked to a near-infrared dye. Following current clinical trial protocols, OTL38 is injected two hours before surgery and is intended to bind to diseased tissue, including several cancers, involving lung, ovarian, and renal. The goal of this technology is to allow the surgeon to see hard-to-detect, small cancer lesions or diseased lymph nodes that might otherwise be missed through the use of a NIR (near-infrared) camera. OTL ligands are designed to enhance the view in real time, and if proven successful, we believe may be an important addition to image-guided surgery.
Our goal; To use our ligands to precisely target overexpressed diseased tissue
- These ligands are designed to enable the delivery of near infrared agents to the diseased tissue, the fluorescence from which is readily identifiable and distinguishable from healthy cells.
- If successfully developed, this would allow the surgeon to identify and excise the cancerous tissue during cytoreductive surgery for cancer.
- On Target Laboratories’ initial work focused on targeting the folate receptor that was overexpressed on cancer cells, but lab research has shown potential applications in other disease states as well.
Prove illuminating probes enable physicians to see with clarity
- With the illuminating probes specifically targeting the cancer, the anticipated benefit is that the surgeon can visualize the precise location of the tumor tissue on a monitor adjacent to the operative field with the help of a non-intrusive imaging system or fluorescent lamp.
- Our clinical studies currently demonstrate the potential applications in patients with ovarian cancer for improved intraoperative staging and more precise cytoreductive surgery. These results remain to be confirmed in larger scale studies.
A small molecule designed with patients in mind
- While non-targeted fluorescent dyes have been shown to passively accumulate in some tumors, the resulting tumor-to-background ratios are often not easy to distinguish, and the boundaries between malignant and healthy tissues can be challenging to define.
- Our technology is different from others of the past because it is targeted to the tumor alone and is cleared from the body after two hours. Additionally, it is convenient because the patient is given the product via IV only two hours before surgery.
Our technology is currently in clinical testing to determine its safety and efficacy in these conditions.