Surgeons used the technique, called Cornell dots, to remove cancerous tissue in 11 patients with Barrett’s esophagus, a pre-cancerous condition that affects the lining of the esophagus and can develop into esophageal adenocarcinoma, a type of cancer with a poor prognosis.
“The beauty of this technique is that it’s simple and the dots can be used with standard endoscopes,” said Dr. John Hunter, a pediatric gastroenterologist at Children’s Hospital of Philadelphia and a professor of pediatrics at the Perelman School of Medicine of the University of Pennsylvania. “Our findings provide promising early evidence for the potential of Cornell dots to improve endoscopic detection of pre-cancer and cancer.”
The researchers reported their findings in a paper published this month in Nature Biotechnology.
Cornell dots are biodegradable spheres made of poly(lactic-co-glycolic acid) (PLGA), a polymer commonly used in sutures and drug-delivery devices. The spheres are embedded with a near-infrared (NIR) dye that glows when illuminated with NIR light, allowing them to be seen by a modified endoscope.
Cornell dots were approved for human clinical trials by the U.S. Food and Drug Administration in 2019.
For the clinical trial, patients with Barrett’s esophagus were given the Cornell dots in a capsule with a glass of water. The dots then adhered to the lining of the esophagus, including any pre-cancerous or cancerous cells.
“The dots are really sticky, so they tend to stay where they’re placed, and the vast majority of them accumulate in the esophagus,” Hunter said.
The patients then underwent endoscopy, during which the modified endoscope was used to illuminate the esophagus and any Cornell dots that had adhered to the tissue. The tissue that lit up was then removed for analysis.
In addition to the 11 patients with Barrett’s esophagus, the researchers also used Cornell dots to visualize pre-cancerous and cancerous tissue in mouse models of esophageal cancer and colon cancer.
“The results in animal models were consistent with what we saw in the clinical trial,” Hunter said. “In the mouse models, we were able to visualize pre-cancerous and cancerous tissue with very clear resolution.”
The researchers are now planning a larger clinical trial to further evaluate the safety and efficacy of Cornell dots for cancer detection and removal.
“We’re excited about the potential of this technology to improve the detection and treatment of cancer,” Hunter said. “We hope that Cornell dots will eventually be used to help patients with a variety of types of cancer.”
