Innovative Drug Enables Nerve Tissue to Emit Light for Safer, Accelerated Surgery

A groundbreaking development in surgical imaging involves a novel drug that attaches to nerve tissues, making them fluoresce during procedures. This innovative drug, called bevonescein, allows surgeons to visualize nerves more clearly, reducing the risk of accidental injury. When administered intravenously, bevonescein binds to nerves and emits light under specific lighting conditions, enhancing intraoperative nerve visibility. This advancement aids surgeons during complex head and neck surgeries, such as tumor removals, lymph node dissections, and thyroid surgeries, where precise identification of cranial nerves is crucial.

The drug was tested in a small Phase 1–2 clinical trial involving 27 cancer patients, demonstrating its safety and efficacy in highlighting longer nerve stretches than visible to the naked eye. Surgeons reported that the fluorescent nerve signals improved their ability to distinguish nerves from surrounding tissue, potentially improving surgical outcomes.

This research, published in Nature Communications, is part of ongoing efforts to improve surgical precision using fluorescence-guided techniques. The drug is rapidly cleared from the body, remaining bound to nerves for up to eight hours, making it suitable for intraoperative use. Surgeons utilize specialized microscopes with filter systems that induce fluorescence, allowing real-time nerve visualization as yellowish-green structures threading through tissue.

The development of bevonescein was influenced by the pioneering work of Quyen Nguyen, MD, Ph.D., and the late Nobel laureate Roger Tsien, Ph.D., whose research in fluorescent proteins laid the foundation for this innovation. Currently, a Phase 3 trial is underway at multiple centers to assess whether the drug's use translates into improved overall surgical success. If approved by the FDA, bevonescein could become a standard tool in surgeries across various medical fields, offering safer procedures and better patient outcomes.

This technology exemplifies how advances in molecular imaging can transform surgical precision and patient safety, potentially across diverse surgical disciplines.