Subjects will undergo infusion of 5 mg/kg indocyanine green, ICG ("TumorGlow") intravenously up to 5-days prior to surgery. Then, during the surgical procedure the next day, the subjects will undergo standard-of-care surgery. During the surgery, the fluorescence from the tumor will be used to localize lesions and ensure the entire tumor has been removed, as well as locate any un-expected tumors. The goal of this protocol is to evaluate safety and collect initial efficacy data using indocyanine green with NIR fluorescence imaging in a pediatric patient population undergoing pulmonary metastatectomy.
1. Male and female children (12 - 17 years of age) with a primary diagnosis, or a high clinical suspicion of a solid tumor with metastasis to the lung warranting surgery based on CT/PET or other imaging 2. Are scheduled to undergo surgical resection for suspected metastasis 3. Female subjects of childbearing potential (including those less than 2 years postmenopausal) agree to use an acceptable form of contraception from the time of signing informed consent until 30 days after infusion of ICG. Male subjects who are are sexually active (and capable of producing sperm) with a partner that could become pregnant, must agree to use an acceptable form of contraception from the time of signing informed consent until 30 days after infusion of ICG.
1. Any medical condition that in the opinion of the investigators could potentially jeopardize the safety of the subject 2. History of anaphylactic reactions to ICG. Subjects with a medical history of 'idiopathic anaphylaxis' will require evaluation 3. A positive serum pregnancy test at screening for female subjects of childbearing potential. Note that subjects with a positive pregnancy test on the day of infusion will be discontinued from study and will not receive the study drug.
Single group
ICG INFUSION 5MG/KG
DrugSubjects will undergo infusion of 5 mg/kg indocyanine green, ICG ("TumorGlow") intravenously up to 5-days prior to surgery.
Number of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)
To assess the safety and tolerability of intravenously infusion of a single dose 5 mg/kg of ICG; 2. To assess the safety and tolerability of using high dose (5 mg/kg) ICG used with Near Infrared (NIR) fluorescent imaging when used with ICG in subjects undergoing pulmonary metastasectomy. Safety will be assessed by the incidence of AEs and SAEs coded using MedDRA. Results will be summarized as the number and percentage of participants with events, categorized by preferred term, system organ class, severity grade, attribution, and timing relative to infusion and surgery. AE rates will be reported with one-sided 90% exact confidence intervals and compared against a 25% unacceptable safety threshold.
Sensitivity of INR
The following secondary efficacy endpoints are only defined for FAS subjects, i.e., subjects undergoing NIR fluorescent imaging with ICG for the detection of primary nodules and/or synchronous lesions
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