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BACKGROUND: Standard biomarker testing of a single macroscopic disease site is unlikely to be sufficient because of tumor heterogeneity. A focus on examining global biomarker expression or activity, particularly in microscopic residual chemotherapy-resistant disease, is needed for the appropriate selection of targeted therapies. This study was aimed at establishing a technique for the assessment of biomarkers of ovarian cancer peritoneal spread. METHODS: An in-house developed fluorescent imaging device was used to detect the expression of the c-Met oncogene in ovarian cancer. A modified cyanine 5-tagged peptide, GE137, with a high in vitro affinity for the human c-Met protein, was tested in a panel of ovarian cancer cell lines. Finally, the feasibility of detecting submillimeter ovarian cancer cell peritoneal metastases in vivo was tested through the intravenous injection of GE137 into mice with tumor xenografts. RESULTS: Using optical imaging it was possible to detect c-Met expression in submillimeter peritoneal metastases that were freshly excised from a human high-grade serous ovarian cancer. GE137 selectively bound to the c-Met tyrosine kinase without activating survival signaling pathways (AKT or extracellular signal-regulated kinase phosphorylation) downstream of c-Met. GE137 specifically accumulated in SKOv3 ovarian cancer cells expressing c-Met via clathrin-mediated endocytosis and emitted a fluorescent signal that lasted for at least 8 hours in tumor xenografts in vivo with a sustained high signal-to-noise ratio. CONCLUSIONS: Our results suggest that intraoperative optical imaging could provide a new paradigm for selecting cancer patients for appropriate targeted therapies, particularly after initial chemotherapy.

Original publication




Journal article



Publication Date





202 - 213


c-Met, fluorescence imaging, minimal residual disease, operative imaging, optical imaging, ovarian cancer, personalized medicine, targeted therapy, Animals, Biomarkers, Tumor, Blotting, Western, Cell Line, Tumor, Feasibility Studies, Female, Flow Cytometry, Fluorescent Dyes, Gene Expression Regulation, Neoplastic, Heterografts, Humans, Immunohistochemistry, Mice, Mice, Inbred BALB C, Mice, Nude, Microscopy, Fluorescence, Molecular Targeted Therapy, Optical Imaging, Ovarian Neoplasms, Peptides, Cyclic, Peritoneal Neoplasms, Precision Medicine, Proto-Oncogene Proteins c-met