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Open AccessArticle

Novel Molecular Targets for Tumor-Specific Imaging of Epithelial Ovarian Cancer Metastases

1
Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
2
Department of Gynecology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
3
Department of Pathology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(6), 1562; https://doi.org/10.3390/cancers12061562
Received: 21 April 2020 / Revised: 22 May 2020 / Accepted: 9 June 2020 / Published: 12 June 2020
(This article belongs to the Special Issue Preclinical and Clinical Advances in Ovarian Cancer)
In epithelial ovarian cancer (EOC), the strongest prognostic factor is the completeness of surgery. Intraoperative molecular imaging that targets cell-surface proteins on tumor cells may guide surgeons to detect metastases otherwise not visible to the naked eye. Previously, we identified 29% more metastatic lesions during cytoreductive surgery using OTL-38, a fluorescent tracer targeting folate receptor-α (FRα). Unfortunately, eleven out of thirteen fluorescent lymph nodes were tumor negative. The current study evaluates the suitability of five biomarkers (EGFR, VEGF-A, L1CAM, integrin αvβ6 and EpCAM) as alternative targets for molecular imaging of EOC metastases and included FRα as a reference. Immunohistochemistry was performed on paraffin-embedded tissue sections of primary ovarian tumors, omental, peritoneal and lymph node metastases from 84 EOC patients. Tumor-negative tissue specimens from these patients were included as controls. EGFR, VEGF-A and L1CAM were highly expressed in tumor-negative tissue, whereas αvβ6 showed heterogeneous expression in metastases. The expression of EpCAM was most comparable to FRα in metastatic lesions and completely absent in the lymph nodes that were false-positively illuminated with OTL-38 in our previous study. Hence, EpCAM seems to be a promising novel target for intraoperative imaging and may contribute to a more reliable detection of true metastatic EOC lesions. View Full-Text
Keywords: epithelial ovarian cancer metastases; surgery; tumor-targeted molecular imaging; near-infrared fluorescence; biomarkers epithelial ovarian cancer metastases; surgery; tumor-targeted molecular imaging; near-infrared fluorescence; biomarkers
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de Muynck, L.D.A.N.; Gaarenstroom, K.N.; Sier, C.F.M.; van Duijvenvoorde, M.; Bosse, T.; Mieog, J.S.D.; de Kroon, C.D.; Vahrmeijer, A.L.; Peters, I.T.A. Novel Molecular Targets for Tumor-Specific Imaging of Epithelial Ovarian Cancer Metastases. Cancers 2020, 12, 1562.

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