Drug that makes tumors glow is transforming cancer surgery

Editor's Note

A new drug is giving surgeons a sharper view of cancer in the OR and helping preserve healthy tissue, Fast Company August 28 reports. Cytalux is an FDA-approved fluorescent agent that makes cancer cells glow green under infrared light, allowing surgeons to spot and remove malignant lesions with greater precision.

As detailed in the article, gynecologic oncologist Arvind Bakhru, MD, MPH, uses the drug during minimally invasive ovarian cancer surgical procedures. When he turns on the infrared light on his laparoscope, tumors become instantly visible, making resection clearer and more accurate. Cytalux is delivered via IV up to 9 hours before ovarian cancer procedures and up to 24 hours before lung cancer operations. The drug works by binding a fluorescent dye to folate receptors, which are over-expressed in most tumors because of their constant cell growth.

The outlet reports the FDA first cleared Cytalux in 2021 for ovarian cancer surgery after a clinical trial showed it could identify not only known lesions but also additional cancerous growths in more than 30% of patients. Approval expanded to lung cancer in 2022, and since commercial launch in September 2023, the drug has been used in over 1,000 procedures.

Thoracic surgeon Ryan Levy, MD, at the University of Pittsburgh Medical Center says Cytalux is proving more effective than dyes applied directly to lung tissue during operations. Unlike traditional methods that risk overlap or leakage, Cytalux highlights cancer cells throughout the lung, improving accuracy and reducing the likelihood that surgeons must return for additional resection. Dr Levy adds the drug has also been vital in localizing small, hard-to-detect lung nodules that previously might have been monitored until they grew larger.

For ovarian cancer patients, Dr Bakhru notes detecting and removing even small, asymptomatic lesions is essential for long-term survival, since symptoms typically appear late in disease progression. Cytalux is currently the only drug of its kind available, though its maker, On Target Laboratories, sees opportunities to expand to other cancers, given that folate receptors are present in 85% of tumors.