{"entity":{"id":"tilmanocept-tc99m","kind":"drug","name":"Technetium-99m tilmanocept","aka":[],"tldr":"The purpose-built tracer for sentinel lymph node mapping in breast cancer, melanoma and oral cancer, replacing off-label sulfur colloid.","summary":"Technetium-99m tilmanocept is a mannosylated dextran labelled with technetium-99m that binds CD206, the mannose receptor on macrophages in lymph nodes. Because it is small it drains rapidly from the injection site, and because it binds a receptor it stays in the sentinel node rather than passing through to second-echelon nodes, which simplifies surgery. It was the first agent purpose-built for sentinel lymph node mapping, replacing off-label sulfur colloid. The FDA approved it in March 2013 for breast cancer and melanoma, in 2014 for sentinel node localisation in oral cavity squamous cell carcinoma, where mapping showed 97.8% sensitivity, and extended it to children in 2017; the EU approved it in 2014. It is detected with a handheld gamma counter in theatre. Tilmanocept finds the first node a cancer would spread to so that only that node needs removal.","status":"approved","asOf":"2026-09-08","wikipedia":"https://en.wikipedia.org/wiki/Tilmanocept","links":[{"label":"Label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Lymphoseek"}],"tags":["gap-fill","diagnostic"],"related":["tc-99m"],"indications":[],"sections":[],"technologies":["spect"],"targets":[],"drugs":[],"companies":["navidea"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Lymphoseek","modality":"Radiopharmaceutical lymphatic mapping agent","mechanism":"Mannosylated dextran that binds CD206 (mannose receptor) on macrophages in sentinel nodes, giving rapid uptake and low pass-through to second-echelon nodes.","approvals":[{"region":"US","year":2013,"indication":"Lymphatic mapping with a handheld gamma counter in breast cancer and melanoma"},{"region":"US","year":2014,"indication":"Sentinel lymph node localisation in oral cavity squamous cell carcinoma"},{"region":"EU","year":2014,"indication":"Sentinel node imaging in breast cancer, melanoma, oral SCC"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/tilmanocept-tc99m/","neighbours":{"isotope":[{"id":"mo-99","kind":"isotope","name":"Molybdenum-99","route":"/isotopes/mo-99/"},{"id":"tc-99m","kind":"isotope","name":"Technetium-99m","route":"/isotopes/tc-99m/"}],"technology":[{"id":"spect","kind":"technology","name":"SPECT & bone scan","route":"/technologies/spect/"}],"company":[{"id":"navidea","kind":"company","name":"Navidea Biopharmaceuticals","route":"/companies/navidea/"}],"term":[{"id":"sentinel-lymph-node-biopsy","kind":"term","name":"Sentinel node biopsy","route":"/terms/sentinel-lymph-node-biopsy/"}],"section":[{"id":"f-infection-imaging","kind":"section","name":"Infection & inflammation imaging","route":"/fronts/f-infection-imaging/"}],"indication":[{"id":"sentinel-node-mapping","kind":"indication","name":"Sentinel lymph node mapping in breast cancer and melanoma","route":"/indications/sentinel-node-mapping/"}]}}