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Fluorescent Imaging with Pafolacianine Expedites Lung Cancer Surgery

• Pafolacianine (Cytalux) offers advantages over traditional imaging by simplifying the localization of small lung nodules during surgery. • The ELUCIDATE trial demonstrated that pafolacianine led to clinically significant changes in surgical approach in 53% of patients. • Intravenous administration of pafolacianine streamlines surgical workflow, eliminating the need for additional procedures and logistical complexities. • The use of pafolacianine with infrared imaging allows for efficient tumor imaging during surgery, without disrupting the normal surgical schedule.

Fluorescent imaging technology using pafolacianine (Cytalux) is streamlining thoracic surgery for lung cancer, offering a more efficient and less disruptive method for identifying and resecting small lung nodules. According to Colleen Gaughan, MD, a thoracic surgeon at AdventHealth Celebration, this approach simplifies the surgical workflow compared to previous methods that involved complex coordination with interventional pulmonologists or radiologists.

Advantages of Pafolacianine

Traditional methods for locating small lung nodules often required matching CT scans to the operative field or employing navigational bronchoscopy or wire localization. These techniques, as Gaughan explained, can be time-consuming, costly, and logistically challenging. Pafolacianine, administered intravenously before surgery, allows surgeons to use an infrared camera to visualize tumors in real-time without disrupting the surgical flow.

ELUCIDATE Trial Results

The phase 3 ELUCIDATE trial demonstrated the clinical significance of pafolacianine. The study found that 53% of patients experienced at least one clinically significant event that led to a meaningful change in the surgical operation (P < .0001). Furthermore, 38% of patients had at least one event within a 10 mm margin of the resected primary nodule (95% CI, 28.5%-48.3%).

Streamlined Surgical Workflow

Dr. Gaughan emphasized that pafolacianine's pre-operative administration eliminates the need for additional procedures or specialized scheduling. "One of the great things about [pafolacianine] is that it is an [intravenous] medication that we give to patients beforehand... then we can do the exploration in surgery with our near infrared camera, and it does not disrupt the flow of the surgery," she stated. This allows surgeons to maintain their normal schedule while gaining valuable intraoperative imaging information.
The adoption of pafolacianine represents a significant advancement in lung cancer surgery, offering a more efficient and precise method for tumor localization and resection.
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Reference News

[1]
Fluorescent Imaging Technology Expedites Thoracic Surgery in Lung Cancer
cancernetwork.com · Dec 6, 2024

Colleen Gaughan, MD, discusses pafolacianine's (Cytalux) advantages over traditional lung cancer imaging methods, highli...

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