The feasibility of folate receptor alpha- and HER2-targeted intraoperative fluorescence-guided cytoreductive surgery in women with epithelial ovarian cancer: A systematic review

Abstract

Targeted fluorescence-guided cytoreductive surgery is feasible in women with epithelial ovarian cancer positive for FRα.• True positive and false positive values ranged from 75 to 77% and 10-25%, respectively.• FRβ-expressing macrophages in lymph nodes cause a cross-reaction with the FRα-targeted imaging agents.

A follicle-stimulating hormone receptor-targeted near-infrared fluorescent probe for tumor-selective imaging and photothermal therapy

“…This particular metastatic pattern makes tumor foci difficult to discern, affecting surgical completeness and postoperative morbidity. Fluorescence image-guided surgery with tumor-targeting by means of folate receptor, HER2, prolactin receptor, CD24 or other biomarkers has shown the potential to improve the detection and resection of tumor foci in ovarian cancer [ 9 , 17 , 18 , [34] , [35] , [36] , [37] , [38] ]. Visible, first-window or second-window NIR real-time imaging systems have been developed in preclinical and clinical settings.…”

Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions

“… 220 , 227 – 229 Folate receptor (FR)-α, which is heavily upregulated in many cancers derived from epithelial cells, has also been advanced as an attractive target for cancer-specific targeting that has been applied to the modification of NPs in tumor and LNM detection-focused research efforts. 218 , 230 – 232 The efficacy of folic acid (FA)-modified nanomedicines, however, appears to be limited by FA-associated increases in IgM absorption to the surface of the prepared liposomes such that they are rapidly removed from systemic circulation and internalized by macrophages within the liver, spleen, and tumor. 233 Macrophage-containing LNs also exhibit detectable FR-β expression, potentially resulting in a false-positive nodal signal when utilizing FR-targeting NPs in a clinical setting.…”

“… 230 , 234 Other targets with less cross-reactivity or the combination of multiple imaging agents and targets of interest may thus represent promising approaches to enabling more reliable imaging-based evaluation of LNM in the future. 232 …”

Updates on fluorescent probes and open‐field imaging methods for fluorescence‐guided cytoreductive surgery for epithelial ovarian cancer: A review

“…de Jong et al. systematically evaluated the clinical and preclinical studies of FGCS that targeted either HER2 or FRα 44 . However, as HER‐2 is expressed only in 20% of OCs, the relevant studies are not summarised in this review.…”