Diagnosing and treating tumors in real time during endoscopy, with theragnostics: the tumor is identified and characterized with a high-resolution ‘optical biopsy’ and, at the same time, treated with ‘cold plasma’ (that does not involve thermal energy and is therefore much safer). This is the core of ‘MULTIPROBE’, a multicenter project conducted by researchers from the Università Cattolica del Sacro Cuore, campus di Roma, Fondazione Universitaria Policlinico Agostino Gemelli IRCCS, Sapienza Università di Roma, and the University of Limoges, France, which won the prestigious ERC Synergy Grant 2025 research competition of the European Research Council.
The main objective of MULTIPROBE is the development of hybrid endoscopes, miniaturized devices that combine diagnostic and therapeutic functions never integrated before, using revolutionary technical innovations that increase the resolution of the acquired images and the contrast for a very powerful optical biopsy, while at the same time increasing the penetration capacity of the treatment.
" In addition, it combines endoscopic capabilities with integrated cold plasma therapy, creating a cutting-edge theragnostic approach in oncology," project supervisors Stefan Wabnitz, from Sapienza University of Rome, Massimiliano Papi, associate professor of physics in the del Dipartimento di Neuroscienze dell’Università Cattolica del Sacro Cuore, Rome, Ivo Boskoski, associate professor of Gastroenterology at the Dipartimento di Medicina e Chirugia Translazionale and Highly specialized Gastroenterologist at Fondazione Policlinico Universitario Agostino Gemelli IRCCS, and Vincent Couderc, from the University of Limoges explain. This significant advance will initially be applied in gastrointestinal (GI) endoscopy, with the aim of extending it to all other relevant medical diagnostic fields.
The Synergy Grant (SyG) promotes substantial advances in the frontier of knowledge and encourages new research as well as new methods and techniques, for groups consisting of 2-4 Principal Investigators (PIs), each of whom may have their own research group. The MULTIPROBE project, which will last four years, will receive funding of over €6 million.
A second ERC Synergy grant in this category has been awarded to researchers at the Università Cattolica del Sacro Cuore, Milan, led by Caterina Giostra, full professor in the Dipartimento di Storia, Archeologia e Storia dell’arte.
Background
In gastrointestinal endoscopy, there is an urgent need for reliable tools for ‘optical biopsy’ and ‘instant pathology’ and real-time treatment. Optical biopsy, or intraoperative tissue assessment and differentiation, characterizes the nature of tissue based on an optical signal. This technology allows physicians to receive immediate feedback during observation, potentially avoiding the need to remove tissue for traditional biopsy. With it it is possible to examine numerous tissues. In addition, optical biopsy can significantly reduce both costs and procedural time. Endoscopy has long been fundamental in the diagnosis and treatment of gastrointestinal disorders, offering a safe and effective approach. However, the current state of the art still relies on the histopathology of tissue samples for a definitive diagnosis of cancer. This leads to critical delays in the initiation of treatment and involves costly laboratory procedures. In addition, conventional biopsy takes weeks to obtain results, further delaying treatment.
Diagnosis and therapy together
MULTIPROBE aims to provide a combined diagnostic and therapeutic tool.
The MULTIPROBE approach represents a revolutionary solution to the challenges encountered in techniques that combine non-linear imaging and instantaneous direct treatment through the use of an innovative endoscopic system that exploits ‘multimode optical fibers’ (which transmit multiple bands of the light spectrum) to illuminate the tissues to be analyzed. This innovation simplifies, reduces costs, and significantly speeds up the beam focusing process. The result is ‘cleaner’ and sharper images than conventional methods, which are therefore more informative about the health of the tissues, Professor Papi explains.
“The multimodal fibers we are developing,” he adds, “exploit physical phenomena such as light condensation, thanks to which the light self-organizes within the fiber, maintaining a stable and coherent beam even when the fiber is bent or subjected to stress (as occurs in biological tissue). This allows us to obtain very high-quality, high-resolution images during endoscopy,” he reiterates.
The therapy uses jets of cold atmospheric plasma, controlled to precisely target and eradicate cancer cells by inducing programmed cell death (apoptosis, immune-mediated in real time) and stopping cell multiplication. What distinguishes plasma therapy is its non-thermal and selective nature, which ensures minimal impact on adjacent healthy tissue. This translates into fewer side effects and an overall improvement in the patient experience, avoiding secondary tissue fibrosis and damage to the vascular and lymphatic systems.
“This innovation is set to revolutionize cancer therapy, eliminating the need for separate procedures and enabling a seamless transition from diagnosis to treatment,” Professors Papi and Boskoski explain. As research progresses, our goal is to bring MULTIPROBE technology from a pioneering concept to clinical practice, ushering in a new era in cancer treatment. Through rigorous testing, we aim to establish this integrated approach as the standard in gastrointestinal oncology, particularly for low- and high-grade gastrointestinal dysplasia and early-stage gastrointestinal cancers. This comprehensive, efficient, and highly effective solution will provide physicians and patients with a powerful tool in their fight against cancer."