Study on operating using illuminated neuroblastoma launched
16 april 2026
Surgeons and researchers have started a new clinical study. They are investigating the best approach to remove neuroblastoma more precisely by illuminating tumor cells during surgery. For the first time worldwide, doctors at the Princess Máxima Center are applying this method in children.
The study builds on promising results from the laboratory. There, researchers tested a fluorescent substance bound to an existing medication in mini‑tumors and in mice. They observed that the substance clearly distinguishes tumor cells from healthy tissue.
In adults, surgery using illuminated tissue is already being performed for several types of cancer. The new study, called GLOW‑FISH, focuses on children with neuroblastoma. Due to the way this childhood cancer grows, it is very difficult to completely remove the tumor during surgery.
During the study, scientists are investigating what dose of the fluorescent substance children should receive. Using calculations, they have already made a good estimate. In the study, they will determine the exact dose. They are also examining whether the fluorescent substance truly helps surgeons remove tumor cells more precisely.
Dr. Willemieke Tummers and Dominique Simons work in the Clinical Research Program for Surgical Oncology at the Máxima Center and are closely involved in the study and research into fluorescence‑guided surgery as project leader and study coordinator. Tummers says: 'We expect that with this method we can operate on a child more precisely. This is because we can more accurately remove the illuminated tumor cells and leave healthy tissue behind. That could improve both the cure rate and the quality of life of children with neuroblastoma.'
Approximately 15 children who need to undergo surgery for neuroblastoma at the Máxima Center will participate in this study. Meanwhile, researchers are exploring whether this surgical method could also be used in the future for children with a bone tumor.
KWF makes this clinical study possible. Villa Joep previously made the laboratory research possible. In that research, investigators tested the fluorescent substance developed by the Clinical Research Program for Surgical Oncology and the Rios group of the Máxima Center, together with Leiden University Medical Center.
Innovative technologies in the operating room
In this combined phase I–II study, the compound anti‑GD2‑IRDye800CW is being investigated. This substance consists of a fluorescent label linked to the antibody dinutuximab. That antibody binds to GD‑2, which is present on the surface of tumor cells. Dinutuximab is used as adjuvant therapy in the treatment of neuroblastoma.
The primary objective of the study is to establish a safe dosage of this new fluorescent substance. In addition, the effectiveness of the fluorescent substance in visualizing neuroblastoma cells is being investigated. The Trial and Data Center of the Máxima Center is coordinating the study.
The application of tumor‑specific fluorescence is one of the developments within surgery being researched at the Máxima. Dr. Lideke van der Steeg, head of pediatric surgery and the Clinical Research Program for Surgical Oncology, is the principal investigator of this study: 'Together with the technical physicians and physician‑researchers working in our research group, we are looking at where we can truly make a difference for children with cancer using innovative technologies. It is very rewarding that what was developed in the laboratory is now finding its way into the operating room within a study setting.'
If this study proves successful, the researchers aim to set up a subsequent study to investigate the added value of fluorescence‑guided surgery in a larger group of children. This could potentially give surgeons and children with neuroblastoma, both within and outside the Máxima, access to this technique in the future.
The fluorescent substance linked to dinutuximab used in the new study was developed through a collaboration between the Clinical Research Program for Surgical Oncology and the Rios group of the Máxima Center, together with the Image‑Guided Surgery group of Prof. Dr. Vahrmeijer at LUMC.
The fluorescent substance administered to the children in the study was produced in the pharmacy of LUMC. To make this possible, the substance first had to be adapted for use in children. Rob Valentijn and Dr. Martin Pool were responsible for these important modifications.
The clinical study is a collaboration with Recordati, the manufacturer of the drug dinutuximab. The Máxima Center has filed a patent application together with LUMC to protect the combination of dinutuximab and the fluorescent compound anti‑GD2‑IRDye800CW.