The Surf trial

2025-523898-42-00 Phase II and Phase III (Integrated) Authorised, recruitment pending

Status Authorised, recruitment pending · 1 EU/EEA countries · 1 sites

Overview

Sponsor-declared trial summary

Phase Phase II and Phase III (Integrated)
Status Authorised, recruitment pending
Participants planned 40
Countries 1
Sites 1

Histologically confirmed solid malignancy (e.g., head and neck, gastrointestinal, hepatobiliary, breast, genitourinary, sarcoma)

To determine the optimal dose and timing of intravenous ICG to achieve sufficient tumor-to background contrast in solid tumors and to evaluate whether ICG fluorescence imaging can accurately identify tumor margins during surgery.

Key facts

Sponsor
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04]
Decision date (initial)
2026-01-13
Transition trial
No
Low-intervention
Yes
Rare-disease indication
No
Vulnerable population
No
Funding sources
Erasmus MC

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Diagnosis

To determine the optimal dose and timing of intravenous ICG to achieve sufficient tumor-to background contrast in solid tumors and to evaluate whether ICG fluorescence imaging
can accurately identify tumor margins during surgery.

Secondary objectives 5

  1. To determine the sensitivity, specificity, PPV, and NPV of fluorescence imaging for tumor detection.
  2. To assess the number and pathology of additional fluorescent lesions identified intraoperatively.
  3. To determine if fluorescence imaging can identify lymph node metastases.
  4. To evaluate the safety and tolerability of ICG at tested doses.
  5. To assess the relationship between standard clinical imaging modalities (CT, MRI, ultrasound, nuclear imaging) and ICG fluorescence with respect to tumor characteristics and perfusion

Conditions and MedDRA coding

Histologically confirmed solid malignancy (e.g., head and neck, gastrointestinal, hepatobiliary, breast, genitourinary, sarcoma)

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 5

  1. Age ≥18 years
  2. Histologically confirmed solid malignancy (e.g., head and neck, gastrointestinal, hepatobiliary, breast, genitourinary, sarcoma)
  3. Candidate for surgical resection with curative intent
  4. Ability to provide written informed consent
  5. Adequate organ function to undergo surgery and ICG administration

Exclusion criteria 5

  1. Known allergy to Indocyanine Green (ICG), iodine, or shellfish
  2. Pregnant or breastfeeding
  3. Significant renal impairment (eGFR <50 mL/min/1.73 m²)
  4. Hyperthyroidism or other active thyroid disease
  5. Any condition deemed by the investigator to place the patient at undue risk or interfere with study procedures

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 2

  1. Tumor-to-background ratio (TBR) ≥ 1.5 on ex vivo imaging of resected specimens.
  2. Proportion of patients with histologically confirmed clear surgical margins (≥1 mm) in fluorescent vs. non-fluorescent areas

Secondary endpoints 5

  1. Concordance between fluorescence signal and histopathology at wound bed and specimen
  2. Number of additional fluorescent lesions biopsied and confirmed as tumor, as well as the number of false-positive and false-negative lesions
  3. Mean fluorescence intensity (MFI) in metastatic vs. non-metastatic lymph nodes
  4. Incidence and severity of adverse events (AEs) and serious adverse events (SAEs)
  5. Concordance of ICG fluorescence with complementary imaging or spectroscopy signals, clinical findings, and histopathological outcomes.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

VERDYE 5 mg/ml poeder voor oplossing voor injectie

PRD10944472 · Product

Active substance
Indocyanine Green
Pharmaceutical form
SOLUTION FOR INJECTION
Route of administration
INFUSION
Max daily dose
5 mg/kg milligram(s)/kilogram
Max total dose
5 mg/kg milligram(s)/kilogram
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
V04CX01 — -
Marketing authorisation
BE273892
MA holder
DIAGNOSTIC GREEN LIMITED
MA country
Belgium
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)

Sponsor organisation
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Address
Dr. Molewaterplein 40
City
Rotterdam
Postcode
3015 GD
Country
Netherlands

Scientific contact point

Organisation
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Contact name
Dr. D.E. Hilling

Public contact point

Organisation
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Contact name
Dr. D.E. Hilling

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Netherlands Authorised, recruitment pending 40 1
Rest of world 0

Investigational sites

Netherlands

1 site · Authorised, recruitment pending
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Department of Surgery, Dr. Molewaterplein 40, 3015 GD, Rotterdam

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 8 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1 Protocol 2025-523898-42-00 clean 2
Protocol (for publication) D1 Protocol 2025-523898-42-00 tracked changes 1.1
Recruitment arrangements (for publication) K1_Recruitment arrangements_clean 1.1
Recruitment arrangements (for publication) K1_Recruitment arrangements_tracked_changes 1.1
Subject information and informed consent form (for publication) L1__NL-NL_SIS and ICF_description_SURF_clean 2
Subject information and informed consent form (for publication) L1__NL-NL_SIS and ICF_description_SURF_tracked_changes 1.1
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC Indocyanine Green 1
Synopsis of the protocol (for publication) D1_Protocol synopsis 2025-523898-42-00 1.0

Application history

2 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2025-10-16 Netherlands Acceptable
2026-01-13
2026-01-13
2 SUBSTANTIAL MODIFICATION SM-1 2026-04-03 Netherlands Acceptable
2026-04-28
2026-04-28