{
  "abstract": "Rationale\n\nImmune checkpoint inhibition (ICI) targeting programmed death-1 or its ligand (PD-1/PD-L1) is being explored as an addition to standard treatment for esophageal cancer (EC) to improve response rates, yet robust methods for patient selection are lacking. The predictive value of PD-L1 expression in biopsies is inconsistent due to intra- and intertumoral heterogeneity, and the impact of neoadjuvant chemoradiotherapy (CRT) on ICI response is unclear. Improving patient selection for receiving ICI therapies in patients with EC requires a better understanding of the drug's distribution and target binding. Here, we investigated the distribution of fluorescently labelled durvalumab (durvalumab-680LT) using ultrasound-guided quantitative fluorescence molecular endoscopy (US-qFME) before and after CRT in 20 patients with EC.Methods\n\nUS-qFME included in vivo mucosal fluorescence imaging, spectroscopic quantification, and biopsy sampling of the tumor and healthy tissue. For dose optimization, 0, 4.5, 15, and 25 mg durvalumab-680LT were used pre-CRT.Results\n\nQuantifying in vivo fluorescence revealed a dose-dependent increase in the durvalumab-680LT signal in tumor tissues pre-CRT, with the highest fluorescence intensity and highest interpatient variability in the 25-mg group (ranges: 4.5 mg: 0.0101-0.0202 mm⁻¹, 15 mg: 0.01295-0.03225 mm⁻¹, 25 mg: 0.01720-0.0514 mm⁻¹). Sixty percent of patients (n = 3 in both dose cohorts) in the 15 mg and 25 mg cohorts exhibited high durvalumab-680LT signals with a tumor-to-healthy tissue ratio ≥2. Lower fluorescence signals were measured post-CRT compared to pre-CRT. Finally, durvalumab-680LT binding to tumor cells was confirmed using fluorescence microscopy.Conclusions\n\nUS-qFME combined with durvalumab-680LT enables the visualization of durvalumab uptake in EC and reveals interpatient variability, supporting its potential future role in selecting patients for ICI therapy.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterology and Hepatology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.",
    "Department of Pathology and Medical Biology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.",
    "Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.",
    "Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.",
    "Department of Gastroenterology and Hepatology, Martini Hospital, Groningen, Van Swietenplein 1, 9728 NT Groningen, The Netherlands.",
    "Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.",
    "Department of Surgery, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.",
    "Early Cancer Institute, Department of Oncology, University of Cambridge, Adrian Way, Cambridge CB2 0XZ, United Kingdom.",
    "Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Anne M van der Waaij"
    },
    {
      "affs": [
        0
      ],
      "name": "Ymke J van Ginkel"
    },
    {
      "affs": [
        0
      ],
      "name": "Pia Volkmer"
    },
    {
      "affs": [
        1
      ],
      "name": "Gursah Kats-Ugurlu"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Henrik K Huizinga"
    },
    {
      "affs": [
        3
      ],
      "name": "Sara Hone Lopez"
    },
    {
      "affs": [
        3
      ],
      "name": "Jacco J de Haan"
    },
    {
      "affs": [
        4
      ],
      "name": "Rina Bijlsma"
    },
    {
      "affs": [
        4
      ],
      "name": "Laurens A van der Waaij"
    },
    {
      "affs": [
        5
      ],
      "name": "Christina T Muijs"
    },
    {
      "affs": [
        5
      ],
      "name": "Anne G H Niezink"
    },
    {
      "affs": [
        6
      ],
      "name": "Boudewijn van Etten"
    },
    {
      "affs": [
        0
      ],
      "name": "Jessie Westerhof"
    },
    {
      "affs": [
        7
      ],
      "name": "Massimiliano di Pietro"
    },
    {
      "affs": [
        8
      ],
      "name": "Dominic J Robinson"
    },
    {
      "affs": [
        2
      ],
      "name": "Marjolijn N Lub-de Hooge"
    },
    {
      "affs": [
        0
      ],
      "name": "Wouter B Nagengast"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/734jkbtdmcmbq.bib",
  "cited_by": 0,
  "doi": "10.7150/thno.136523",
  "fulltext_url": "https://europepmc.org/articles/PMC13684177",
  "id": "734jkbtdmcmbq",
  "issns": [
    "1838-7640"
  ],
  "landing_url": "https://europepmc.org/article/MED/42909237",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Cancer Immunotherapy and Biomarkers"
    ]
  ],
  "openalex": "W7207796046",
  "pdf_url": "https://europepmc.org/articles/PMC13684177?pdf=render",
  "pmcid": "PMC13684177",
  "pmid": "42909237",
  "published": "2026-09-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/734jkbtdmcmbq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:14Z",
      "native_id": "MED:42909237",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42909237"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Cancer Immunotherapy and Biomarkers",
      "subfield": "oncology"
    }
  ],
  "title": "Visualizing the distribution of durvalumab targeting PD-L1 using quantitative fluorescence imaging in patients with esophageal cancer.",
  "title_text": "Visualizing the distribution of durvalumab targeting PD-L1 using quantitative fluorescence imaging in patients with esophageal cancer.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:14Z",
  "url": "https://research.draconitic.com/paper/734jkbtdmcmbq",
  "venue": "Theranostics",
  "versions": []
}