Researchers discovered that a new fluorescent dye called pafolacianine, which glows under special light, can help surgeons see cancer cells in children and teenagers during operations. The dye targets a specific marker found on many childhood cancers. Scientists tested tissue samples from various pediatric tumors and found that this marker was present in many of them. This is exciting because the dye is already approved for use in adults with cancer, and this study suggests it might also work well for young patients. If proven safe and effective in clinical trials, this tool could help surgeons remove tumors more completely during surgery.

The Quick Take

  • What they studied: Whether a new glowing dye (pafolacianine) can help surgeons see cancer cells in children and teenagers by lighting up a specific marker found on tumor cells
  • Who participated: Tissue samples from pediatric and adolescent patients with various solid tumors (the exact number of samples wasn’t specified in the abstract), plus computer analysis of genetic data from cancer databases
  • Key finding: The folate receptor marker that the dye targets was found to be widely expressed across many different types of childhood and teenage cancers, suggesting the dye could potentially help surgeons in many cases
  • What it means for you: If further testing confirms safety and effectiveness, this technology might one day help surgeons remove childhood cancers more completely during surgery, potentially improving outcomes. However, this is early-stage research, and much more testing in actual patients is needed before it becomes standard practice.

The Research Details

This was a laboratory research study that examined cancer tissue samples from pediatric patients. Researchers used a special staining technique called immunohistochemistry to look for a specific protein marker (folate receptor) on cancer cells. They stained the tissue samples with special dyes that highlight this marker and measured how much of it was present. Additionally, the researchers looked at publicly available genetic information from cancer databases to see which childhood cancers naturally produce high levels of this marker. This two-part approach—examining actual tissue samples and analyzing genetic data—gave them a comprehensive picture of whether the new fluorescent dye would likely work across different types of childhood cancers.

Understanding which cancers have this specific marker is crucial before testing a new treatment tool in actual patients. By studying tissue samples and genetic data first, researchers can predict which young patients might benefit from this technology without putting anyone at risk. This laboratory work is an essential step before moving to clinical trials with real patients.

This study represents important preliminary research that identifies a promising opportunity. However, readers should know that this is laboratory-based evidence, not clinical evidence from actual patients. The sample size of tissue samples wasn’t specified, which makes it harder to assess how representative the findings are. The next critical step would be testing this dye in actual surgical procedures with pediatric cancer patients to confirm it works safely and effectively in real-world conditions.

What the Results Show

The research found that the folate receptor marker—the target that pafolacianine dye binds to—is widely present across many different types of solid tumors in children and adolescents. This is significant because it suggests the dye could potentially be useful for a broad range of pediatric cancers, not just one or two specific types. The presence of this marker means that when surgeons use the fluorescent dye during surgery, it would likely light up cancer cells in many different pediatric patients. The genetic analysis of publicly available cancer data confirmed these findings, showing that various childhood tumor types naturally express high levels of both forms of the folate receptor (FRα and FRβ). This consistency between the tissue sample analysis and the genetic data strengthens the conclusion that this marker is a reliable target across pediatric cancers.

The study identified that both forms of the folate receptor (alpha and beta versions) are present in pediatric tumors, which is important because the pafolacianine dye can target both forms. This means the dye would work against a wider range of cancer cells. The research also demonstrated that the fluorescence-guided surgery approach represents a new generation of cancer surgery tools that are more targeted than older methods, potentially offering better precision in identifying and removing cancer tissue.

Pafolacianine is the first of a new generation of targeted fluorescent dyes approved for cancer surgery in adults. Previous surgery tools relied on older dyes like indocyanine green, which don’t specifically target cancer cells. This research extends the potential use of pafolacianine from adults to children, suggesting that what works in adult cancers might also work in pediatric cancers. However, pediatric cancers often behave differently than adult cancers, so this finding is particularly valuable because it shows the marker is present in childhood tumors specifically.

The study has several important limitations. First, the exact number of tissue samples examined wasn’t clearly specified, making it difficult to assess how thoroughly the research was conducted. Second, this is laboratory research only—it shows the marker is present in cancer cells but doesn’t prove the dye will work safely or effectively during actual surgery in children. Third, the study doesn’t address whether the dye would be safe for pediatric patients or how much of it could be used. Finally, the research doesn’t compare how well this dye performs compared to other surgical guidance methods. Much more research, including clinical trials with actual patients, is needed before this becomes a standard treatment tool.

The Bottom Line

Based on this research, the next logical step is to conduct clinical trials testing pafolacianine in pediatric cancer surgery. However, this is not yet a recommendation for clinical use—it’s a research finding suggesting the approach is worth investigating further. Parents and patients should not expect this technology to be available immediately, as safety and effectiveness testing in children will take time. Confidence level: This is preliminary evidence suggesting promise, but not yet proven in actual patients.

This research is most relevant to pediatric cancer surgeons, oncologists, and families of children with solid tumors. It’s particularly important for researchers developing new cancer treatment tools. Families should be aware of this emerging technology but should not seek it out yet, as it’s still in the research phase. This finding may eventually benefit children with various types of solid tumors, including brain tumors, kidney tumors, and other cancers.

This is very early-stage research. If clinical trials begin soon, it could take 5-10 years or more before this technology becomes available for pediatric patients, assuming it proves safe and effective. Families should discuss emerging treatment options with their oncology team but should focus on current, proven treatments for now.

Want to Apply This Research?

  • For families managing pediatric cancer, track surgical outcomes and recovery milestones (surgery date, time to return to normal activities, any complications) in a health app to have complete records for your medical team and to monitor progress over time.
  • Stay informed about clinical trials in your area by regularly checking ClinicalTrials.gov and discussing emerging treatment options with your child’s oncology team at each appointment. Ask specifically about fluorescence-guided surgery trials if your child has a solid tumor.
  • Maintain a comprehensive health record including all imaging results, pathology reports, and surgical notes. Share this information with your medical team and keep copies for your records. This documentation will be valuable if new treatment options like fluorescence-guided surgery become available.

This research describes laboratory findings about a new surgical tool that is not yet approved for use in children. Pafolacianine is currently approved only for adult cancer surgery. This article is for educational purposes and should not be interpreted as medical advice or a recommendation for treatment. Parents and patients should discuss all treatment options, including emerging technologies, with their pediatric oncology team. Clinical trials may eventually test this approach in children, and families interested in participating should consult with their medical providers about eligibility and safety considerations.