School of Materials Science and Engineering, Central South University, Changsha, Hunan, 410083, China.
Furong Laboratory, Central South University, Changsha, Hunan, 410008, China.
Adv Mater. 2024 Aug;36(32):e2405253. doi: 10.1002/adma.202405253. Epub 2024 Jun 5.
Breast-conserving surgery is the favorable option for breast cancer patients owing to its advantages of less aggressiveness and better cosmetic outcomes over mastectomy. However, it often suffers from postsurgical lethal recurrence due to the incomplete removal of microscopic tumors. Here, a surface-enhanced Raman scattering (SERS) surgical strategy is reported for precise delineation of tumor margins and intraoperative real-time elimination of microscopic tumor foci, which is capable of complete surgical removal of breast tumors and significantly improve the outcomes of breast-conserving surgery without local tumor recurrence. The technique is chiefly based on the human epidermal growth factor receptor 2 (HER2)-targeting SERS probes with integrated multifunctionalities of ultrahigh sensitive detection, significant HER2 expression suppression, cell proliferation inhibition, and superior photothermal ablation. In a HER2+ breast tumor mouse model, the remarkable capability of the SERS surgical strategy for complete removal of HER2+ breast tumors through SERS-guided surgical resection and intraoperative real-time photothermal elimination is demonstrated. The results show complete eradiation of HER2+ breast tumors without local recurrence, consequently delivering a 100% tumor-free survival. Expectedly, this SERS surgical strategy holds great promise for clinical treatment of HER2+ breast cancer with improved patients' survival.
保乳手术因其侵袭性较小和比乳房切除术更好的美容效果，成为乳腺癌患者的首选。然而，由于对显微镜下肿瘤的不完全切除，它常常遭受术后致命性复发。在这里，我们报道了一种表面增强拉曼散射（SERS）手术策略，用于精确描绘肿瘤边界，并在术中实时消除显微镜下的肿瘤灶，从而能够完全切除乳房肿瘤，并显著改善保乳手术的效果，而不会出现局部肿瘤复发。该技术主要基于人表皮生长因子受体 2（HER2）靶向 SERS 探针，具有超高灵敏度检测、显著抑制 HER2 表达、抑制细胞增殖和优异光热消融的综合多功能性。在 HER2+乳腺癌小鼠模型中，通过 SERS 引导的手术切除和术中实时光热消除，该 SERS 手术策略具有完全切除 HER2+乳腺癌肿瘤的显著能力。结果显示，HER2+乳腺癌肿瘤完全消除，无局部复发，因此实现了 100%无肿瘤存活。预计，这种 SERS 手术策略将为 HER2+乳腺癌的临床治疗带来改善患者生存的巨大希望。
