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Tozuleristide is a first-in-class, tumor-targeting fluorescent imaging agent designed for intraoperative visualization of cancerous tissues. It consists of a synthetic peptide (chlorotoxin, CTX) derived from the venom of the deathstalker scorpion (Leiurus quinquestriatus), conjugated to the near-infrared fluorescent dye indocyanine green (ICG). The CTX moiety selectively binds proteins overexpressed in tumor microenvironments, such as matrix metalloproteinase-2 (MMP-2) and neuropilin-1 (NRP1), leading to accumulation in cancerous tissue. Upon excitation with a compatible NIR imaging system, the ICG component fluoresces, enabling real-time differentiation between tumor and healthy tissue during surgery. Tozuleristide is under development primarily for pediatric central nervous system tumors but has also been studied in adult glioma, skin cancers, breast cancer, and other solid tumors. It has demonstrated favorable safety and tolerability profiles across multiple Phase 1 trials and is currently being evaluated in pivotal Phase 2/3 studies using proprietary imaging systems[1][4][5][6][7][9].
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