What is Pafolacianine: Uses, Dosage, Side Effects and More

Pafolacianine is a fluorescent imaging agent that helps surgeons see cancer cells more clearly during operations. This specialized medication works like a highlighter for cancer tissue, making it glow under special infrared light so doctors can better identify and remove tumors while preserving healthy tissue.

The drug represents a significant advancement in surgical precision, particularly for ovarian cancer procedures. It's given through an IV before surgery and accumulates in cancer cells, helping surgeons navigate complex operations with greater confidence and accuracy.

What is Pafolacianine Used For?

Pafolacianine is primarily used to help surgeons identify ovarian cancer tissue during surgery. The medication acts as a visual guide, highlighting cancer cells that might otherwise be difficult to distinguish from healthy tissue with the naked eye.

This imaging agent is specifically approved for adult women undergoing surgery for suspected or confirmed ovarian cancer. It helps surgeons make more informed decisions about which tissue to remove and which to preserve, potentially improving surgical outcomes.

The drug is also being studied for other types of cancer surgery, though ovarian cancer remains its primary approved use. Your surgical team will determine if this imaging agent is appropriate for your specific situation.

How Does Pafolacianine Work?

Pafolacianine works by targeting folate receptors, which are proteins found in high concentrations on many cancer cells. Think of these receptors as docking stations that cancer cells use to gather nutrients they need to grow and survive.

Once injected into your bloodstream, the medication travels throughout your body and attaches to these folate receptors. Cancer cells typically have many more of these receptors than healthy cells, so the medication accumulates more heavily in cancerous tissue.

During surgery, your surgeon uses a special infrared camera system to see where the medication has collected. The cancer tissue appears to glow or fluoresce under this special light, creating a clear visual distinction between healthy and cancerous areas.

This is considered a moderate-strength imaging agent that provides valuable information without significantly altering your body's normal functions. The medication doesn't treat the cancer itself but serves as a surgical navigation tool.

How Should I Take Pafolacianine?

Pafolacianine is given only by healthcare professionals through an intravenous (IV) line in a hospital or surgical center. You won't take this medication at home or by mouth.

The medication is typically administered 1 to 9 hours before your surgery begins. Your medical team will determine the exact timing based on your specific procedure and medical needs.

You don't need to take this medication with food or milk since it's given directly into your bloodstream. However, your surgical team may give you specific instructions about eating or drinking before your procedure, which you should follow carefully.

The preparation process is straightforward. Your nurse will start an IV line and slowly inject the medication over several minutes. You'll then wait for the appropriate time before your surgery begins.

How Long Should I Take Pafolacianine For?

Pafolacianine is given as a single dose before surgery, not as an ongoing treatment. You'll receive the medication once, and it will work throughout your surgical procedure.

The medication remains active in your system for several hours, which is sufficient time for most surgical procedures. Your body will naturally eliminate the medication over the following days without any additional treatment needed.

Unlike many medications that require daily doses or extended treatment courses, pafolacianine is designed for one-time use. There's no need to worry about remembering to take doses or managing a complex medication schedule.

What Are the Side Effects of Pafolacianine?

Most people tolerate pafolacianine well, with side effects being generally mild and temporary. The most common reactions occur shortly after receiving the injection and typically resolve quickly.

Here are the side effects you might experience, keeping in mind that many people have no noticeable reactions at all:

Common side effects include:

• Nausea or mild stomach upset
• Temporary discoloration of urine (may appear yellow or green)
• Mild skin reactions at the injection site
• Brief dizziness or lightheadedness
• Temporary changes in how things taste

Less common but more serious side effects may include:

• Allergic reactions with symptoms like rash, itching, or difficulty breathing
• Significant changes in blood pressure
• Severe nausea or vomiting
• Chest pain or heart rhythm changes
• Severe injection site reactions

Your medical team will monitor you closely after receiving the medication and throughout your surgery. If you experience any concerning symptoms, they're well-prepared to address them immediately.

Who Should Not Take Pafolacianine?

Pafolacianine isn't suitable for everyone, and your medical team will carefully review your health history before deciding if it's right for you. The medication has specific contraindications that make it unsuitable for certain people.

You should not receive pafolacianine if you have a known allergy to the medication or any of its components. Your doctor will discuss any previous allergic reactions you've had to medications or imaging agents.

People with severe kidney disease may not be good candidates for this medication, as the body relies on kidney function to eliminate the drug. Your doctor will review your kidney function tests before making this decision.

If you're pregnant or breastfeeding, the safety of pafolacianine hasn't been fully established. Your medical team will weigh the benefits and risks carefully in these situations.

Certain heart conditions or blood pressure problems may also make this medication unsuitable. Your surgeon and anesthesiologist will review your complete medical history to ensure your safety.

Pafolacianine Brand Names

Pafolacianine is marketed under the brand name Cytalux in the United States. This is the primary commercial name you'll likely encounter when discussing this medication with your healthcare team.

The medication may be referred to by its generic name (pafolacianine) or brand name (Cytalux) interchangeably in medical settings. Both names refer to the same medication with identical properties and effects.

When scheduling your surgery or reviewing your treatment plan, you might see either name used in your medical records or discharge instructions. Don't worry if you see both names - they're the same medication.

Pafolacianine Alternatives

Currently, there are limited direct alternatives to pafolacianine for fluorescence-guided surgery in ovarian cancer. Traditional surgical approaches rely on the surgeon's visual assessment and experience without fluorescent guidance.

Other imaging techniques used during surgery include intraoperative ultrasound, which uses sound waves to create real-time images of internal structures. However, this provides different information than fluorescent imaging.

Some medical centers use other fluorescent agents for different types of cancer surgery, but these aren't typically interchangeable with pafolacianine for ovarian cancer procedures.

Your surgeon will discuss the best approach for your specific situation, which may include using pafolacianine, traditional surgical techniques, or a combination of methods to achieve the best possible outcome.

Is Pafolacianine Better Than Other Imaging Methods?

Pafolacianine offers unique advantages over traditional surgical imaging methods, particularly in its ability to highlight cancer tissue in real-time during surgery. This can be especially valuable in complex cases where cancer tissue might be difficult to distinguish from healthy tissue.

Traditional surgical approaches rely primarily on the surgeon's visual assessment, tactile examination, and experience. While these methods are effective, they don't provide the additional visual information that fluorescent imaging offers.

Compared to other imaging techniques like CT scans or MRI, pafolacianine provides information during the actual surgery rather than before it. This real-time guidance can help surgeons make more informed decisions about tissue removal.

The choice between pafolacianine and other approaches depends on your specific situation, the complexity of your surgery, and your surgeon's expertise. Many surgeons use multiple techniques together for the best possible outcomes.