# Technetium-99m tilmanocept

Source: https://onco.cc/drugs/tilmanocept-tc99m/  
OnCo record `tilmanocept-tc99m` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-08
- Tags: gap-fill; diagnostic
- 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: US 2013: Lymphatic mapping with a handheld gamma counter in breast cancer and melanoma; US 2014: Sentinel lymph node localisation in oral cavity squamous cell carcinoma; EU 2014: Sentinel node imaging in breast cancer, melanoma, oral SCC

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Tilmanocept
- Label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Lymphoseek

## Connected records

- cancers: [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Melanoma](https://onco.cc/cancers/melanoma/)
- technologies: [Sentinel lymph node biopsy](https://onco.cc/technologies/sentinel-node/), [SPECT & bone scan](https://onco.cc/technologies/spect/)
- companies: [Navidea Biopharmaceuticals](https://onco.cc/companies/navidea/)
- trials: [Breast and Melanoma Trial With Lymphoseek to Identify Lymph Nodes](https://onco.cc/trials/nct01106040/), [Evaluation of Sentinel Lymph Nodes in Head and Neck Squamous Cell Carcinoma](https://onco.cc/trials/nct00911326/), [Personalized Neck Radiation Therapy Directed by Sentinel Lymph Node Biopsy for the Treatment of Oral Cavity Squamous Cell Carcinoma, PRECEDENT Trial](https://onco.cc/trials/nct07121595/), [Trial of Lymphoseek in Intraoperative Localization of Lymph Nodes in Breast Cancer and Melanoma](https://onco.cc/trials/nct00671918/)
- terms: [Sentinel node biopsy](https://onco.cc/terms/sentinel-lymph-node-biopsy/)

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