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Although watch-and-wait is an option for complete responders, current imaging cannot reliably identify them, with about 30% regrowth. To improve response assessment and guide resections, PH10 was developed as a topically applied pH-activatable near-infrared fluorescent probe for rapid, tumor-specific imaging.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/real-time-detection-of-colorectal-cancer-using-topical-application-of-a-ph-activatable-fluorophore/349394/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/real-time-detection-of-colorectal-cancer-using-topical-application-of-a-ph-activatable-fluorophore/349394.png","ImageObject",300,407,{"name":92,"@type":93},"Aldword","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-23","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does PH10 aim to solve in colorectal cancer care?","Question",{"text":112,"@type":113},"PH10 targets the difficulty of accurately visualizing tumors after neoadjuvant chemoradiation and during surgery, which can lead to incomplete resections and uncertainty in identifying complete responders for watch-and-wait.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How is PH10 administered and what makes it tumor-specific?",{"text":117,"@type":113},"PH10 is topically applied and is pH-activatable, using near-infrared fluorescence that becomes active in the acidic tumor microenvironment, supporting specificity without systemic administration or prolonged incubation.",{"name":119,"@type":110,"acceptedAnswer":120},"What performance was reported for PH10 in imaging?",{"text":121,"@type":113},"In vivo, PH10 achieved a median tumor-to-background ratio of 3.2 within 1 minute in murine models. Ex vivo on human samples, it reached a median TBR of 2.2 within 10 minutes.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},349394,1790173193,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Molecular Diagnosis & Therapy (2026) 30:689–706 [https://doi.org/10.1007/s40291-026-00853-6](https://doi.org/10.1007/s40291-026-00853-6)  \nReal‑Time Detection of Colorectal Cancer Using Topical Application of a pH‑Activatable Fluorophore  \nDaan G. J. Linders1 · Jinhui Ser2 · Md Shamim3 · Aida Baibussunova2 · Jasmijn C. J. Loggers1 · Gilbert Noordam4 · Davey van den Burg4 · Gijs J. D. van Acker5 · Onno R. Guicherit5 · Marinke Westerterp5 · Peter J. K. Kuppen1 ·  \nAndreas W. K. S. Marinelli5 · Denise E. Hilling1,6 · Elke E. M. Peters4 · Satoshi Kashiwagi2 · Maged Henary3 · Hak Soo Choi2 · Alexander L. Vahrmeijer1  \nReceived: 29 December 2025 / Accepted: 28 April 2026 / Published online: 23 May 2026 © The Author(s) 2026  \nAbstract  \nIntroduction Standard treatment for locally advanced rectal cancer involves neoadjuvant chemoradiation therapy (nCRT) followed by total mesorectal excision, but this approach carries significant morbidity and often results in incomplete resections owing to poor intraoperative tumor visualization. For patients with complete response to nCRT, a watch-and-wait (W&W) strategy can spare surgery, but current imaging techniques inadequately identify complete responders, leading to regrowthin ~ 30% of cases. To improve nCRT response assessment and guide resections, we developed PH10, a topically applied, pH-activatable near-infrared (NIR) fluorescent probe for rapid, tumor-specific imaging.  \nMethods PH10, a small-molecule cyanine analog, was tested in murine models and on human tumor specimens (n = 11) . Fluorescence activation, tumor specificity, and tumor-to-background ratio (TBR) were evaluated in vivo and ex vivo within clinically relevant timeframes.  \nResults PH10 enabled rapid and specific tumor visualization, achieving a median TBR of 3.2 within 1 min in vivo in murine models and 2.2 within 10 min ex vivo on human samples. The probe demonstrated high specificity for tumor tissue within the acidic tumor microenvironment without requiring systemic administration or prolonged incubation.  \nConclusions PH10 is a promising, fast-acting topical NIR agent for real-time tumor detection during colorectal cancer endoscopy and surgery. Its simplicity and rapid kinetics support potential clinical translation. Moreover, its pH-activatable mechanism may extend its utility to other solid cancers with acidic microenvironments.  \nExtended author information available on the last page of the article  \n1 Introduction  \nCurative-intent treatment for locally advanced rectal cancer consists of neoadjuvant chemoradiation therapy (nCRT) followed by total mesorectal excision, a procedure associated with significant postoperative complications and morbidity, such as anastomotic leakage, stoma-related issues, urinary incontinence, impotence, and bowel dysfunction [1–5] . The complex anatomy of the distal rectum and nCRT-induced fibrosis complicate the accurate identification of tumor boundaries during surgery, resulting in tumor-positive surgical margins in up to 20% of cases [6, 7] . Such incomplete resections significantly increase the risk of local recurrence, negatively affect overall survival, and often necessitate additional treatments, leading to increased patient morbidity and higher healthcare costs [6, 8, 9] .  \nApproximately 15–20% of patients with rectal cancer who undergo nCRT achieve a pathological complete  \nresponse (pCR), defined as no residual tumor cells found in the resected specimen [10 , 11] . For these patients, an organ-preserving watch-and-wait (W&W) strategy offers a potential alternative to surgery, aiming to maintain quality of life [12–14]. However, accurately identifying pCR preoperatively remains challenging owing to the limitations of conventional imaging techniques, such as magnetic resonance imaging (MRI) and endoscopy. This discrepancy between clinical complete response (cCR) and pCR contributes to local regrowth rates of up to 38% in patients managed with W&W and underscores the need for imp","cbCaiecuKtgFTZHf","https://ap.wps.com/l/cbCaiecuKtgFTZHf","pdf",1892991,18,"English","# Introduction\n## Neoadjuvant therapy challenges and margin positivity\n## Complete response identification and watch-and-wait limitations\n## Need for endoscopic and intraoperative tumor detection\n## PH10 concept and rationale for topical pH-activatable imaging","[{\"question\":\"What problem does PH10 aim to solve in colorectal cancer care?\",\"answer\":\"PH10 targets the difficulty of accurately visualizing tumors after neoadjuvant chemoradiation and during surgery, which can lead to incomplete resections and uncertainty in identifying complete responders for watch-and-wait.\"},{\"question\":\"How is PH10 administered and what makes it tumor-specific?\",\"answer\":\"PH10 is topically applied and is pH-activatable, using near-infrared fluorescence that becomes active in the acidic tumor microenvironment, supporting specificity without systemic administration or prolonged incubation.\"},{\"question\":\"What performance was reported for PH10 in imaging?\",\"answer\":\"In vivo, PH10 achieved a median tumor-to-background ratio of 3.2 within 1 minute in murine models. Ex vivo on human samples, it reached a median TBR of 2.2 within 10 minutes.\"}]","Real-Time Detection of Colorectal Cancer Using Topical Application of a pH-Activatable Fluorophore | PDF",1790083124,45]