For a surgical oncologist, the most commonly asked question by patients after an operation is, “Did you get all the cancer?” The answer is most commonly, “I removed everything I could see.
Improving Cancer Surgery with Optical Imaging
There remains a critical need to improve success rates for oncologic surgery. Currently, surgeons can only make gross estimations of what should be removed during the cancer resection.
As an oncologic surgeon with a lab that has explored the role of optical imaging to improve cancer surgery over the past decade, I am uniquely suited to assist with the translation of this technology to the clinic; my lab is uniquely suited to conduct preclinical research and clinical translation of novel imaging modalities in cancer treatement.
Preclinical work with tumor targeting antibodies provided high tumor to background ratios in head and neck, skin, breast, brain and other cancers. This work eventually led to IND-enabling toxicology studies that permitted successful first in human clinical trial using near infrared labeled antibodies for surgical and pathological navigation during head and neck cancer surgery.
We have successfully obtained INDs for first in human clinical trials evaluating the role of fluorescently labeled antibodies in cancer surgery (cetuximab and panitumumab). The role of this technology is being investigated to guide surgical excision, identify positive margins during ex vivo examination by the surgeon, and reduce sampling error in surgical pathology. Our clinical trials have helped develop methodologies to understand the role of this technology in improving surgical outcomes in oncology for a range of tumor types.
Real-time cancer imaging. We have are currently evaluating a variety of novel tumor targeting probes, including a several antibodies labeled with near infrared fluorescent dyes. Working with collaborators at Stanford, University of Alabama at Birmingham, and from around the world we are developing novel probes, dyes and devices for real-time cancer detection. Furthermore, we have developed industry relationships that have allowed collaborative academic-industry development of probes and hardware. We hare in the process of developing these novel probes and agents for optical imaging, ultrasound, optoacoustic imaging, and raman spectroscopy.
Additional projects are being conducted to evaluate novel mechanisms by which these probes identify cancer, and if they can be used to predict the success of targeted therapies. Furthermore, industry and academic relationships have allowed obtaining early phase agents for preclinical studies. Use of radiotracers for whole body and real time optical imaging.
My lab has been involved in several early phase clinical trials to evaluate targeted therapy.
Concurrently with my laboratory work in the role of growth factors in the promotion and development of head and neck cancer, I developed a series of early phase investigator initiated clinical trials using targeted agents as adjuvant therapy. These trials have focused on the role of anti-EGFR small molecule inhibitors as adjuvant therapy and the use of a novel gene therapy for ‘suicide gene’ based therapy.
Tumor-stromal interactions in head and neck cancer. Research here defined CD147 as a therapeutic target. My initial work demonstrated the dependence of head and neck cancer tumor growth on stromal derived growth factors. We showed that fibroblasts promoted growth through growth factor expression and elaboration of proteases to facilitated the invasive phenotype. This led us to the recognition that CD147, also known at extracellular matrix protease inducer (EMMPRIN), promotes growth and invasion and could serve as a therapeutic target in head and neck cancer. CD147 represents a strong opportunity for targeted therapy in head and neck cancer.
About Eben Rosenthal, MD
Eben Rosenthal is a surgeon-scientist and academic leader. He is currently serving as the John and Ann Doerr Medical Director of the Stanford Cancer Center, a position he has held since July 2015. He works collaboratively with the Stanford Cancer Institute and Stanford Health Care leaders to set the strategy for the clinical delivery of cancer care across Stanford Medicine and growing cancer networks.
Before coming to Stanford, he learned his surgical skills in otolaryngology from the University of Michigan and traveled west for further training in facial plastic and reconstructive surgery at the Oregon Health and Science University. He joined the faculty at University of Alabama at Birmingham where he started as an Assistant Professor of Surgery within the Division of Otolaryngology. In 2012, Dr. Rosenthal became Division Director of Otolaryngology – Head and Neck Surgery and the holder of the John S. Odess Endowed Chair at the University of Alabama at Birmingham. He specializes in the treatment and reconstruction of head and neck cancer patients. He has a strong interest in development of new strategies to surgically repair complex head and neck defects to improve functional and cosmetic outcomes.
He has published over 160 peer-reviewed scientific manuscripts, authored many book chapters and published a book on optical imaging in cancer. He has received grant funding from the American Cancer Society, NIH/NCI and NIH/NIDCR to study the role of targeted therapy and novel imaging strategies in cancer.
Contact the Lab
Center for Clinical Sciences Research (CCSR)
Stanford, CA 94305