Technetium (99mTc) tilmanocept

Technetium (^99mTc) tilmanocept, sold under the brand name Lymphoseek, is a radiopharmaceutical diagnostic imaging agent used to locate lymph nodes which may be draining from tumors, and assist doctors in locating lymph nodes for removal during surgery.^[6]

Technetium (^99mTc) tilmanocept

Clinical data
Trade names	Lymphoseek
Other names	technetium Tc 99m tilmanocept
AHFS/Drugs.com	Micromedex Detailed Consumer Information
License data	US DailyMed: Tilmanocept
Pregnancy category	AU: C
Routes of administration	Intradermal, subcutaneous, intratumor
ATC code	V09IA09 (WHO)
Legal status
Legal status	AU: S4 (Prescription only)[1][2] UK: POM (Prescription only)[3] US: ℞-only[4] EU: Rx-only[5]
Pharmacokinetic data
Elimination half-life	1.75 to 3.05 hours at injection site
Identifiers
IUPAC name Dextran 3-[(2-aminoethyl)thio]propyl 17-carboxy-10,13,16-tris(carboxymethyl)-8-oxo-4-thia-7,10,13,16-tetraazaheptadec-1-yl 3-[[2-[[1-imino-2-(D-mannopyranosylthio)ethyl]amino]ethyl]thio]propyl ether technetium-99m complexes
CAS Number	1262984-82-6
UNII	8IHI69PQTC
KEGG	D11543
Chemical and physical data
Formula	(C6H10O5)n(C19H28N4O9S99mTc)3–8(C13H24N2O5S2)12–20(C5H11NS)0–17
Molar mass	15,281–23,454 g/mol[4]

The most common side effects include pain or irritation at the injection site.^[7]

It was approved for medical use in the United States in March 2013,^[4][7] and in the European Union in November 2014.^[5]

Medical uses

In the US, technetium (^99mTc) tilmanocept is indicated with or without scintigraphic imaging for lymphatic mapping using a handheld gamma counter to locate lymph nodes draining a primary tumor site in people with solid tumors for which this procedure is a component of intraoperative management; and guiding sentinel lymph node biopsy using a handheld gamma counter in people with clinically node negative squamous cell carcinoma of the oral cavity, breast cancer or melanoma.^[4][7]

In the EU, technetium (^99mTc) tilmanocept is indicated for imaging and intraoperative detection of sentinel lymph nodes draining a primary tumor in adults with breast cancer, melanoma, or localized squamous cell carcinoma of the oral cavity.^[5] External imaging and intraoperative evaluation may be performed using a gamma detection device.^[5]

History

The safety and effectiveness of technetium (^99mTc) tilmanocept were established in two clinical trials of 332 participants with melanoma or breast cancer.^[7] All participants were injected with technetium (^99mTc) tilmanocept and blue dye, another drug used to help locate lymph nodes.^[7]