Oct. 21, 2025
As a result of improved imaging and screening procedures, lung cancer is detected and diagnosed earlier than ever before. Surgical resection of known or suspected lung cancer lesions is the most effective course of treatment for early-stage non-small cell lung cancer (NSCLC). NSCLC makes up 80% to 85% of all lung cancer cases.
Mayo Clinic in Arizona is among the first medical centers in the Southwest region and the first in Arizona to use pafolacianine, a drug that provides advanced intraoperative imaging of early-stage lesions during lung cancer surgery. The medication helps thoracic surgeons detect and remove small lung cancer lesions that would otherwise be difficult to see.
"Detecting lung cancer in the early stages, when it's most treatable, can significantly improve patient outcomes, says Staci E. Beamer, M.D., chair of Thoracic Surgery at Mayo Clinic in Arizona. "Enhanced visualization of lung cancer lesions during surgery means that we have an additional tool in our arsenal of innovative treatment options to more effectively treat patients with early-stage lung cancer."
Improved lung preservation
Pafolacianine is the only Food and Drug Administration-approved fluorescent imaging technology available for use during lung cancer surgery. Dr. Beamer explains that the drug is administered by IV up to 24 hours before surgery and binds to folate receptors that are present on lung cancer cells. The medication's dye lights up when viewed with a near-infrared camera designed to detect fluorescent chemical imaging.
The results of a randomized clinical trial published in the Journal of Thoracic and Cardiovascular Surgery reported no adverse events related to pafolacianine occurred. The study reported that the drug helped surgeons find lung cancer lesions that could not be found with conventional approaches, including white light and palpation, in 19% of patients. In addition, pafolacianine helped surgeons identify lesions that were not found on preoperative imaging studies in 8% of patients. And surgeons changed the planned scope of their procedure in 29% of cases based on the improved visualization provided by pafolacianine. In 73% of cases, malignant lesions were found outside of the predetermined surgical area.
"The increased visualization helps us to accurately detect and remove early-stage lung cancers, which can be very challenging," says Dr. Beamer. "This increased level of accuracy improves direct visualization of clear surgical margins and helps us to preserve as much lung tissue and capacity as possible."
Increased operative efficiency
Folate receptor medications provide intraoperative imaging that enhances precision during minimally invasive surgical procedures to remove suspected or confirmed lung cancer lesions. These medications also decrease the time a patient spends in the operating room during the initial surgery and reduce the need for follow-up surgeries to remove additional lesions.
"Without tools to help with visualization of small cancers, lung cancer surgery can require a long time in the operating room or result in the need to remove larger portions of the lung," says Dr. Beamer. "This tool helps us to efficiently target and remove early-stage lesions using minimally invasive and robotic surgical techniques that reduce the rate of postsurgical complications and shorten recovery time for patients."
For more information
Sarkaria IS, et al. Pafolacianine for intraoperative molecular imaging of cancer in the lung: The ELUCIDATE trial. The Journal of Thoracic and Cardiovascular Surgery. 2023;166:e468.
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