Lung cancer remains the world’s leading cause of cancer-related death, yet even when a tumor is detected early enough for surgery, removing it completely can be difficult. Small nodules may be hidden deep within the lung, surrounded by normal tissue, or difficult to distinguish by touch and sight. Surgeons must balance the need to eliminate every cancerous cell with the need to preserve as much healthy lung as possible. A new research project at Stanford Medicine aims to give surgeons a molecular “beacon” that could make tumors visible during the operation itself.
Natalie Lui, MD, an associate professor of cardiothoracic surgery at Stanford School of Medicine, has received a multi-year R01 research project grant from the National Institutes of Health to develop and study a fluorescent molecular imaging agent for lung cancer surgery. The project, titled “Intraoperative Molecular Imaging of Lung Cancer Using Panitumumab-IRDye800,” will investigate whether the agent can help surgeons locate tumors more accurately and confirm that suspicious tissue has been fully removed.
The approach combines panitumumab, an antibody that targets the epidermal growth factor receptor, or EGFR, with IRDye800, a near-infrared fluorescent dye. EGFR is a protein found on the surface of cells and is often present at much higher levels in lung cancer than in neighboring healthy lung tissue. After administration, the antibody component is designed to bind preferentially to EGFR-rich tumor cells. The attached dye can then emit a near-infrared signal that is captured by a specialized fluorescence camera in the operating room.
Unlike conventional imaging methods that may require radiation, additional scans, or bulky localization equipment, molecular fluorescence could be incorporated directly into the surgical workflow. During an operation, the camera would illuminate tissue and reveal areas producing the characteristic signal. In principle, this could help surgeons identify a tumor’s boundaries, find lesions that are difficult to see or feel, and examine the surgical field for residual cancerous tissue before closing the incision.
The need for improved localization is particularly urgent as lung cancer screening becomes more widespread. Screening with low-dose computed tomography can detect tumors at smaller sizes, when surgery may offer the best chance of cure. However, smaller tumors can be challenging to locate during minimally invasive or robotic procedures. Lesions that are deep within the lung or have a low density may not create an obvious surface abnormality, forcing surgeons to rely on preoperative markers, intraoperative imaging, or removal of a larger amount of surrounding tissue.
Panitumumab-IRDye800 is intended to address this problem through biology rather than anatomy alone. By recognizing a molecular feature associated with cancer, the agent could potentially distinguish malignant tissue from normal lung even when the tumor’s physical appearance is subtle. The technology may also support more precise surgical decision-making, helping doctors determine whether a nodule is in the expected location and whether the margins—the edges of the removed specimen—appear free of fluorescent tumor signal. The research will be needed to establish how reliably the agent performs and how it should be used safely in patients.
Dr. Lui’s project brings together specialists from several fields. Co-investigators include Stanford researchers Guolan Lu, PhD, from the Department of Urology; Michael Ozawa, MD, from Pathology; Kavitha Ramchandran, MD, and Nathaniel Myall, MD, from Medical Oncology; Tushar Desai, MD, from Pulmonary Medicine; and Summer Han, PhD, from Neurosurgery and Computational Medicine. Eben Rosenthal, MD, of Vanderbilt University’s Department of Otolaryngology–Head and Neck Surgery, is also part of the research team. Their combined expertise spans thoracic surgery, cancer biology, pathology, pulmonary medicine, computational analysis, and image-guided procedures.
The project builds on Lui’s clinical and research work in thoracic oncology. As a board-certified thoracic surgeon at Stanford Hospital, she specializes in general thoracic surgery, lung cancer treatment, and robotic approaches. She also serves as surgical director of the Stanford Lung Cancer Screening Clinic, where she has worked to expand screening and public awareness through education and community outreach. Her laboratory studies additional strategies for improving lung cancer care, including the use of artificial intelligence to predict recurrence and methods for advancing robotic surgical education.
The NIH funding period is scheduled to run from July 7, 2026, through June 30, 2031. During that period, the investigators will work to determine whether panitumumab-IRDye800 can become a practical and clinically useful tool for lung cancer operations. The ultimate goal is not simply to make tumors glow, but to translate that signal into better surgical precision: complete removal of cancer, fewer unnecessary complications, preservation of healthy lung tissue, and a lower risk that disease will return. If successful, the strategy could help move lung cancer surgery toward a future in which molecular information is visible at the exact moment and place it is needed most.
Subject of Research: Development of a near-infrared molecular imaging agent, panitumumab-IRDye800, for locating lung cancer tumors during surgery.
Article Title: Stanford Researchers Develop Fluorescent Molecular Beacon to Guide Lung Cancer Surgery
Web References: https://reporter.nih.gov/search/FJnVv8IJfUutHwqp4qGyKw/project-details/11297505; https://profiles.stanford.edu/natalie-lui
Image Credits: Courtesy of Dr. Natalie Lui, Stanford Medicine
Keywords: Lung cancer, thoracic surgery, molecular imaging, medical imaging, fluorescence-guided surgery, panitumumab-IRDye800, IRDye800, EGFR, robotic surgery, cancer research, Stanford Medicine, NIH R01
