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AHN Cancer Institute leads clinical trial of fluorescent agent that "lights up" previously undetectable cancer cells to guide surgical resection


News provided by

Allegheny Health Network

Aug 25, 2023, 08:15 ET

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Matthew Martens with his dog, Lola
Matthew Martens with his dog, Lola

OncoNano's pegsitacianine shows promising results for patients with invasive abdominal cancers

PITTSBURGH, Aug. 25, 2023 /PRNewswire-PRWeb/ -- When 55-year-old Matthew Martens began rapidly losing weight and couldn't eat, he knew something was wrong. The Edina, Minnesota, resident went to his local health care provider and was diagnosed with stage 4 appendiceal cancer following a CT scan.

He initially received surgery for his cancer in Minnesota upon his diagnosis in 2016. However, in April 2021, his cancer came back with a vengeance.

Early results of this clinical trial suggest that by combining pegsitacianine with surgery, we are better able to remove all of a patient's existing cancer in one procedure, removing all cancer from the patient in one sweep.

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After turning to four health care providers near his hometown for answers on the best course of treatment, he was told that there were no options for his advanced reoccurring disease, which had spread to other parts of his body.

That's when Martens discovered a Facebook support group for patients who have been diagnosed with pseudomyxoma peritonei – a rare type of cancer that typically forms via a cyst on the appendix – as well as related peritoneal surface malignancies.

That Facebook group soon led him to the Allegheny Health Network (AHN) Cancer Institute's David Bartlett, MD, and Patrick Wagner, MD, both renowned surgeons specializing in surgery for this cancer and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). Other patients in the worldwide group had shared their stories about successful surgery and HIPEC treatments by Drs. Bartlett and Wagner at AHN, and encouraged Martens to pursue the same.
After receiving a second opinion from the clinicians at the AHN Cancer Institute, Martens traveled to Pittsburgh in early 2022 for his HIPEC procedure. However, there was a new investigational option to accompany his surgery – Martens was also a participant in OncoNano Medicine's Phase 2 trial of pegsitacianine, a special chemical agent that "lights up" cancer cells by reacting with the cancer's acidity.

HIPEC therapy involves bathing the patient's abdominal cavity with a heated chemotherapy solution to kill off microscopic cancer cells, or small tumors that are tucked in the many folds and crevices of the abdominal cavity and can't be reached by intravenous chemotherapy. The chemo solution is heated to between 107 and 109 degrees, hot enough to destroy cancer cells, but not healthy tissue.

Prior to the 90-minute HIPEC bath, though, the patient undergoes a cytoreduction, also known as a tumor debulking, of the abdominal cavity. That surgery involves the manual removal of all visible tumors – a surgery that can take five hours or more.

And that's where the pegsitacianine comes in. A day or two before the surgical procedure, a patient is injected with pegsitacianine. After the abdominal debulking surgery begins, surgeons use an infrared camera to investigate and remove "glowing" cancer bits that otherwise would have been missed by the naked eye. Once the cytoreduction is complete, the HIPEC bath begins.

Dr. Wagner served as one of the investigators on the trial that uses pegsitacianine, which ultimately proved to be a game-changer for Martens' procedure. This new investigational therapy gives surgeons the option to make highly invasive abdominal surgeries more effective and complete following a cancer diagnosis.

"Pegsitacianine can make cancerous tumors fluorescent under a certain light wavelength, which can be extremely beneficial to surgeons who may not be able to see every cancerous lesion using the naked eye during surgery," said Dr. Wagner. "Early results of this clinical trial suggest that by combining pegsitacianine with surgery, we are better able to remove all of a patient's existing cancer in one procedure, removing all cancer from the patient in one sweep."

For Martens, the pegsitacianine agent allowed Dr. Wagner to remove cancerous areas in his rectum and bladder that they wouldn't have caught otherwise.

"Mr. Martens' case is highly encouraging, as are the other successes observed to date in this trial," said Dr. Wagner. "We look forward to validating these findings in the upcoming Phase 3 trial."

Pegsitacianine has been shown to "light up" tumors in all parts of the body, but Phase 2 of the study focused specifically on abdominal cancers and the agent's utility during cytoreductive surgery. In study results presented during the American Society of Clinical Oncology's annual meeting in early June, Dr. Wagner announced that in half of the patients who received the pegsitacianine, additional pathology-confirmed cancers were discovered through the camera investigation – tiny tumors that otherwise would not have been detected or removed during the typical standard of care surgery.

In other words, the fluorescent agent helped surgeons find more tumors than they normally would have, giving patients like Martens a better chance of a successful cytoreduction surgery and HIPEC procedure. And because the cancer cells are more readily visible, pegsitacianine has the potential to reduce the length of the surgery, which can involve hours of searching around the abdomen and between different organs.

It's been over a year since Martens' procedure at AHN. He's back in Minnesota and he continues to complete follow-up telehealth visits with his doctors at AHN to monitor his progress. He currently has no evidence of disease within his body.

About the Allegheny Health Network – and the AHN Cancer Institute
Allegheny Health Network is a western Pennsylvania-based integrated healthcare system that serves patients from across a five-state region that includes western Pennsylvania and the adjacent regions of Ohio, West Virginia, Maryland, and New York. The Network's Cancer Institute employs more than 200 physicians and 500 oncology professionals who provide a complete spectrum of oncology care at 24 affiliated oncology clinics, including access to state-of-the-art technologies and new therapies being explored in hundreds of clinical cancer trials. The Cancer Institute has the only cancer program in the Pittsburgh region accredited as an Integrated Network Cancer Program by the American College of Surgeons Commission on Cancer, and its radiation oncology program is the largest in the country accredited by the American Society for Radiation Oncology. AHN Cancer Institute is a Quality Oncology Practice Initiative certified practice, and is accredited by the Foundation for Accreditation of Cellular Therapy, National Accreditation Program for Breast Centers and the National Accreditation Program for Rectal Cancer.

About OncoNano Medicine
OncoNano Medicine is developing a new class of products that utilize principles of molecular cooperativity in their design to exploit pH as a biomarker to diagnose and treat cancer with high specificity. Our product candidates and interventions are designed to help patients across the continuum of cancer care and include solid tumor therapeutics, agents for real-time image guided surgery and a platform of immuno-oncology therapeutics that activate and guide the body's immune system to target cancer. OncoNano's lead development candidate is pegsitacianine, a novel fluorescent nanoprobe using the ON-BOARD platform, that is being studied as a real-time surgical imaging agent for use in multiple cancer surgeries and is advancing towards a pivotal clinical trial to aid in tumor detection of peritoneal carcinomatosis. ONM-501, OncoNano's second development program, is a next generation STING (STimulator of INterferon Genes) agonist that is advancing towards a first in human trial in the first half of 2023. Pegsitacianine and ONM-501 have been supported by grants received from the Cancer Prevention Research Institute of Texas. Learn more at http://www.OncoNano.com.

Media Contact

Emily Beatty, Allegheny Health Network, 5136789620, [email protected], www.ahn.org

SOURCE Allegheny Health Network

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AHN Cancer Institute
AHN Cancer Institute
AHN Cancer Institute

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