Rosenthal Lab

Research Light Guided Surgery

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.

Removing Tumors with Fluorescent Dye

Light Guided Surgery uses fluorescent markers that light up the tumor during surgery. 

We are currently investigating if this approach will help surgeons to remove tumor tissue. 

Today, surgeons rely on their vision and touch to assess what should be removed during tumor resection; however, 15-30% of all head and neck cancer patients leave the operation room with tumor cells left behind. For these patients, the chances of tumor recurrence are high and overall survival low.

We are currently investigating if Light Guided Surgery could help solve this problem.


How We Investigate in LGS

1) Infusion of fluorescent dye that reaches the tumor.

2) The tumor will light up with a specialcamera d uring surgery.

3) The surgeon will outline the tumor.

4) The surgeon will remove the tumor.

5) After tumor resection, the surgeon checks the wound bed for remaining cancer.

6) The tumor is removed.

Surgical Imaging

Examples of how LGS could potentially change surgery in the future

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.

Assessment of tumor extent

25% of patients leave the operation room with tumor cells left behind.


Detection of a second tumor

Second tumors represent the second leading cause of death in head and neck cancer patients.


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.



Targeted Therapy

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.

Patient with a tongue tumor underwent system injection of a tumor specific contrast agent that identified subclinical tumor by fluorescence imaging.  The tongue cancer was imaged both in the operating room and in pathology (shown).

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

Eben Rosenthal | Professor and Medical Director Stanford Cancer Center

Nynke van den Berg | PostDoc

Stefania Chirita | Study Coordinator

Subject: Study Trial NCT02741470

Tel: (650) 723 - 1423