VISUALIZE Trial: Abenacianine Helps Surgeons Locate Hard-to-Find Lung Tumors

Gavin Wright, MBBS, discusses the clinical gap that prompted his research into abenacianine (VGT-309), a tumor-targeted fluorescence imaging agent for lung cancer surgery, and the topline results of the phase 2b VISUALIZE trial (NCT06145048).

Wright explains that the shift from open thoracotomy to minimally invasive video-assisted and robotic thoracic surgery has improved recovery and long-term survival for patients, but it has also cost surgeons the ability to feel for tumors by hand. That loss is compounded by wider use of CT screening, which is turning up smaller, harder-to-locate tumors, and by a shift toward sublobar resections that preserve more healthy lung tissue. Together, these trends leave surgeons needing more precise intraoperative information than they currently have.

Abenacianine is designed to help close that gap. The agent is a fluorophore that binds selectively to cancer tissue and fluoresces under near-infrared light, using imaging capability already built into standard video-assisted and robotic surgical systems, allowing surgeons to visualize tumors they cannot see or feel directly. In the VISUALIZE trial, all 89 enrolled patients received the agent and had near-infrared imaging turned on during surgery, and investigators tracked what the study defined as clinically significant events: tumors the surgeon otherwise struggled to find, additional tumors, lymph node involvement, or distant spread within the chest.

Wright reports that a clinically significant event occurred in close to half of patients, including a case in which a lymph node previously biopsied as negative fluoresced during surgery and was confirmed malignant on removal, changing that patient's treatment course. He describes the finding as evidence that the technology is providing surgeons with new, actionable information rather than simply producing an image.

Read the full interview with Dr Wright.