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Last Updated: December 20, 2025

CLINICAL TRIALS PROFILE FOR INDOCYANINE GREEN


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505(b)(2) Clinical Trials for indocyanine green

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Formulation NCT00071227 ↗ Eye Injections of Triamcinolone Acetonide for Retinal Blood Vessel Disorders Completed National Eye Institute (NEI) Phase 1 2003-10-15 This study will evaluate the safety and effectiveness of a new formulation of triamcinolone acetonide for the treatment of retinal blood vessel disorders. Triamcinolone is a steroid drug that decreases inflammation and scarring and is routinely used to treat eye inflammation or swelling. The commercially available form of this drug is associated with potentially harmful side effects thought to be due to preservatives in the preparation. This study will use a formulation that does not contain these potentially harmful preservatives. Preliminary findings from other studies suggest that injection of steroids in the eye can reduce retinal thickening and improve vision. However, they may also cause mild discomfort and lead to vision-threatening conditions. The effects of the drug on the conditions under study in this protocol are not known. Patients with the following conditions involving disorders of retinal blood vessels may be eligible for this study: - Choroidal neovascularization associated with age-related macular degeneration (50 years of age and older) - Macular edema associated with retinal vein occlusion (18 years of age and older) - Diabetic macular edema ((18 years of age and older) Participants undergo the following tests and procedures: - Medical history and physical examination - Eye examination to assess visual acuity (eye chart test) and eye pressure, and to examine pupils, lens, retina and eye movements. The pupils will be dilated with drops for this examination. - Fluorescein angiography to evaluate the eye's blood vessels. A yellow dye is injected into an arm vein and travels to the blood vessels in the eyes. Pictures of the retina are taken using a camera that flashes a blue light into the eye. The pictures show if any dye has leaked from the vessels into the retina, indicating possible blood vessel abnormality. - Indocyanine green angiography to identify feeder vessels that may be supplying abnormal blood vessels. This procedure is similar to fluorescein angiography, but uses a green dye and flashes an invisible light. - Optical coherence tomography to measure retinal thickness. This test shines a light into the eye and produces cross-sectional pictures of the retina. These measurements are repeated during the study to determine if retinal thickening is getting better or worse, or staying the same. - Stereoscopic color fundus photography to examine the back of the eye. The pupils are dilated with eye drops to allow examination and photography of the back of the eye. - Triamcinolone acetonide injection to treat the eye. A numbing eye drop, an antibiotic eye drop, and an injected antibiotic are put in the eye before triamcinolone acetonide is injected into the eye's vitreous (jelly-like substance inside the eye). After the injection, the patient lies on his or her back for 30 minutes. An antibiotic eye ointment is used for 2 days following treatment. - Blood tests to measure liver and kidney function. Patients return to the clinic for follow-up visits 1, 4, and 7 days, and 1 month after the first treatment. Patients whose condition does not improve after 3 months do not receive any more injections, but return for eye examinations at least once a year for 3 years. Patients whose condition improves with treatment return for follow-up visits 6 and 9 months after the first injection and then every 6 months for 2 more years. At each visit, a determination is made whether another injection is needed. After each repeat injection, patients return for follow-up visits at 1, 4, and 7 days after the injection.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for indocyanine green

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00002901 ↗ Docetaxel in Treating Patients With Solid Tumors and Abnormal Liver Function Completed National Cancer Institute (NCI) Phase 1 1996-12-01 RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase I trial to study the effectiveness of docetaxel in treating patients with advanced solid tumors that have not responded to standard therapy or for which there is no effective therapy.
NCT00002901 ↗ Docetaxel in Treating Patients With Solid Tumors and Abnormal Liver Function Completed City of Hope Medical Center Phase 1 1996-12-01 RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. PURPOSE: Phase I trial to study the effectiveness of docetaxel in treating patients with advanced solid tumors that have not responded to standard therapy or for which there is no effective therapy.
NCT00043680 ↗ Celecoxib to Treat Macular Degeneration in Patients Receiving Photodynamic Therapy Completed National Eye Institute (NEI) Phase 2 2002-08-01 This study will determine whether the drug celecoxib (Celebrex® (Registered Trademark)) can help stabilize or improve vision in patients with age-related macular degeneration (AMD) who are receiving photodynamic therapy, or PDT (also called cold laser treatment). The macula is the part of the retina in the back of the eye that determines central or best vision. AMD can severely impair central vision, affecting a person's ability to read, drive, and carry out daily activities. This vision loss is caused by the formation of abnormal new blood vessels in the choroid-a thin, pigmented vascular layer of the eye behind the retina-that leak blood under the macula. PTD stops the growth of these blood vessels and slows the rate of vision loss. However, the treatment usually does not cause vision to improve, and it has only a temporary effect, requiring several treatments over 2 years. Furthermore, PDT does not work in all patients and may actually cause some swelling and re-growth of blood vessels. Celecoxib is an anti-inflammatory drug that, in animal studies, has prevented the growth of abnormal blood vessels associated with tumors and with injury to the cornea. Thus, the drug might reduce swelling and prevent vessel re-growth in AMD, enhancing the effectiveness of PDT. Patients 55 years of age and older with AMD and visual acuity of 20/20 to 20/200 may be eligible for this study. Participants will be randomly assigned to take either celecoxib or a placebo (a look-alike pill with no active drug) twice a day and undergo the various tests and procedures detailed below. Not every examination will be done at every visit, but all may be required at one visit. - Medical history and physical examination - Blood drawing: A blood sample is drawn from an arm vein to evaluate liver and kidney function - Eye examination: Visual acuity and eye pressure are measured, and the lens, retina, pupils and eye movements are examined - Photography: Photographs of the eye are taken using a special camera with a bright flash - Fluorescein angiography: Pictures of the retina are taken to look for abnormal blood vessels. A yellow dye is injected into an arm vein and travels to the blood vessels in the eyes. The retina is photographed using a camera that flashes a blue light into the eye. The pictures show if any dye has leaked from the vessels into the retina, indicating possible blood vessel abnormality. - Indocyanine green angiography: This procedure, similar to fluorescein angiography, uses a green dye to photograph the retina and identify portions of abnormal vessels in the deepest part of the retina. - Optical coherence tomography: This new technique uses light to produce a 2-dimensional cross-sectional picture of the retina. The patient looks into a machine called an optical coherence tomograph at a pattern of flashing and rotating red and green lights, first with one eye and then the other. One week after starting the study medications, laser treatment will begin. For this procedure, a needle is placed in an arm vein and a chemical called verteporfin (Visudyne® (Registered Trademark)) is infused into the vein over 10 minutes. After 15 minutes, the eye is anesthetized with numbing drops. A special contact lens is then placed on the eye and the laser beam is directed to the eye for 83 seconds. Patients will be followed in the clinic every 6 weeks for 36 weeks for various examinations and possible re-treatment, if needed. Some patients will be asked to return 1 to 2 weeks after the first PDT for an eye examination and fluorescein angiography.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for indocyanine green

Condition Name

Condition Name for indocyanine green
Intervention Trials
Breast Cancer 19
Polypoidal Choroidal Vasculopathy 9
Gastric Cancer 7
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Condition MeSH

Condition MeSH for indocyanine green
Intervention Trials
Breast Neoplasms 25
Macular Degeneration 14
Lung Neoplasms 12
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Clinical Trial Locations for indocyanine green

Trials by Country

Trials by Country for indocyanine green
Location Trials
United States 117
China 23
Korea, Republic of 14
France 11
Belgium 11
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Trials by US State

Trials by US State for indocyanine green
Location Trials
California 15
Texas 13
Maryland 13
New York 12
Pennsylvania 11
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Clinical Trial Progress for indocyanine green

Clinical Trial Phase

Clinical Trial Phase for indocyanine green
Clinical Trial Phase Trials
PHASE4 9
PHASE3 2
PHASE2 5
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Clinical Trial Status

Clinical Trial Status for indocyanine green
Clinical Trial Phase Trials
Completed 107
Recruiting 48
Not yet recruiting 28
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Clinical Trial Sponsors for indocyanine green

Sponsor Name

Sponsor Name for indocyanine green
Sponsor Trials
National Cancer Institute (NCI) 20
National Eye Institute (NEI) 11
M.D. Anderson Cancer Center 8
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Sponsor Type

Sponsor Type for indocyanine green
Sponsor Trials
Other 301
Industry 44
NIH 39
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Clinical Trials Update, Market Analysis, and Projection for Indocyanine Green

Last updated: October 28, 2025

Introduction

Indocyanine Green (ICG) is a near-infrared fluorescent dye approved by the U.S. Food and Drug Administration (FDA) in 1959 for hepatic function testing and ophthalmic angiography. Its unique optical properties, including high absorption in the near-infrared spectrum and rapid clearance through the liver, have catalyzed increasing interest in its applications across diagnostic imaging, surgical guidance, and innovative theranostics in recent years. This comprehensive analysis offers an update on recent clinical trials, evaluates market dynamics, and projects future growth trajectories for ICG-based applications.


Clinical Trials Landscape for Indocyanine Green

Recent Clinical Trials and Emerging Applications

The landscape of ICG clinical research has expanded dramatically over the past five years. According to ClinicalTrials.gov, over 150 active or completed trials focus on ICG, with a marked uptick in studies examining its use in oncological, cardiovascular, and neurological domains.

Oncological Imaging

ICG's ability to delineate tumor margins has been a focal point. Trials such as NCT03776823 evaluated ICG-enhanced fluorescence for sentinel lymph node mapping in breast cancer, demonstrating high sensitivity and specificity. Similarly, NCT03915655 investigated ICG for intraoperative visualization of hepatocellular carcinoma (HCC) margins, showing promise in improving surgical outcomes.

Vascular and Cardiac Imaging

ICG's high affinity for vascular structures has facilitated studies like NCT04225891, exploring real-time intraoperative assessment of graft patency during coronary artery bypass grafting (CABG). These trials underscore ICG’s growing role in intraoperative decision-making, reducing postoperative complications.

Lymphatic System Imaging

Trials such as NCT04567874 have explored ICG for lymphatic mapping in melanoma and gynecologic cancers, demonstrating high accuracy in identifying lymphatic pathways.

Neurological Applications

Emerging trials, including NCT04687218, investigate ICG in microvascular neurosurgery for cerebral bypass procedures, aiming to improve the visualization of cerebral vasculature.

Innovations and Future Directions

Recent research explores ICG-functionalized nanocarriers for targeted imaging and drug delivery, such as nanoparticles conjugated with tumor-specific ligands, broadening its theranostic potential.

Regulatory and Safety Updates

ICG's safety profile remains robust, with adverse events being rare and predominantly mild hypersensitivity reactions. The recent approvals for new indications, like fluorescence cholangiography, reflect regulatory confidence. However, ongoing vigilance for allergic responses in sensitive populations guides clinical practice.


Market Analysis

Global Market Size and Historical Growth

The global ICG market was valued at approximately $350 million in 2022 and is projected to grow at a compound annual growth rate (CAGR) of 8-10% through 2030. This expansion aligns with rising adoption in minimally invasive surgeries, oncological diagnostics, and cardiovascular procedures.

Key Market Drivers

  • Advancements in Molecular Imaging Technologies: Integration of ICG with hybrid imaging systems such as near-infrared (NIR) fluorescence cameras has enhanced visualization capabilities, broadening clinical utility.
  • Rising Prevalence of Cancer and Cardiovascular Diseases: The growing burden of oncological and cardiovascular conditions globally has increased demand for real-time intraoperative imaging.
  • Minimal Invasive Surgery Trends: The shift toward laparoscopic and robotic surgeries favors the use of ICG for tumor localization, perfusion assessment, and lymphatic mapping.
  • Regulatory Approvals and Expanded Indications: Recent clearances, including those for ICG in cholangiography and coronary bypass, have catalyzed market expansion.

Key Market Players

Major companies involved in ICG manufacturing and commercialization include:

  • Akorn Inc. (sold to Fresenius Kabi)
  • Daiichi Sankyo Company, Ltd.
  • Pfizer Inc. (discontinued ICG but historically active)
  • Abbott Laboratories
  • Diagnostic Green GmbH

Emerging players and biotech firms are developing specialized formulations and conjugates, further intensifying competition.

Regional Market Dynamics

  • North America: Leading the market due to high adoption in surgical and oncological imaging, supported by robust healthcare infrastructure.
  • Europe: Growing market driven by aging populations and technological advancements.
  • Asia-Pacific: Fastest CAGR (~12%), driven by expanding healthcare access, increased surgical procedures, and favorable regulatory environments.

Market Projections

Forecasts suggest the ICG market will reach $700–$750 million by 2030. The key growth vectors include:

  • Integration with Technological Innovations: Combining ICG with artificial intelligence (AI)-driven image analysis will enhance diagnostic accuracy.
  • Emerging Therapeutic Applications: Nanotechnology-based ICG formulations for targeted therapy will present new revenue streams.
  • Expanding Indications: Clinical validation in neurosurgery, oncology, and cardiology will drive uptake.

The adoption of ICG in robotic and image-guided surgery systems is anticipated to accelerate market growth, especially as minimally invasive techniques become standard practice.


Regulatory and Commercial Challenges

Despite its favorable profile, hurdles include:

  • Allergic Reactions: Although rare, hypersensitivity necessitates caution and screening.
  • Limited Commercial Encapsulation and Targeting: Developing targeted ICG formulations for specific tissues or pathologies requires significant R&D investments.
  • Market Penetration in Emerging Economies: Cost barriers and regulatory approval delays hinder widespread adoption.

Addressing these challenges through innovation and strategic collaborations will be vital for sustained market expansion.


Key Takeaways

  • Clinical trial activity for ICG is on the rise, with notable progress in intraoperative imaging across oncology, cardiovascular, and neurological fields.
  • The global ICG market is poised for significant growth, driven by technological integration, expanding indications, and an increasing prevalence of chronic diseases.
  • Advancements in nanotechnology and hybrid imaging are expected to unlock new applications, unlocking further market potential.
  • Regulatory clarity and safety profiles reinforce confidence, although addressing adverse event concerns remains essential.
  • Strategic partnerships and innovation investments will be crucial for manufacturers aiming to capitalize on emerging trends.

FAQs

1. What are the main applications of indocyanine green in clinical practice?
ICG is primarily used for angiography, tumor margin delineation during surgery, lymphatic mapping, and vascular perfusion assessment, thanks to its near-infrared fluorescence properties.

2. Are there any safety concerns associated with ICG use?
Adverse reactions are rare but include hypersensitivity, especially in individuals with iodine allergy. Proper screening reduces risk, and safety profiles remain favorable.

3. How is ICG integrated into modern surgical procedures?
ICG is administered intravenously, then visualized using near-infrared imaging devices integrated into laparoscopic or open surgical systems for real-time tissue perfusion and anatomy visualization.

4. What are the recent innovations expanding ICG's therapeutic potential?
Development of nanocarriers, conjugates with targeting ligands, and combined diagnostic-therapeutic (theranostic) platforms are expanding ICG’s role beyond imaging towards targeted therapy.

5. What factors will influence ICG market growth over the next decade?
Innovations in imaging technology, regulatory approvals for new indications, increasing surgical procedures, and technological integrations such as AI will be major growth drivers.


References

  1. ClinicalTrials.gov. "Indocyanine Green Trials." [URL]
  2. MarketWatch. "Indocyanine Green Market Analysis." [URL]
  3. FDA. "Indocyanine Green Approval and Safety Data." [URL]
  4. International Journal of Surgical Oncology. "ICG Applications in Surgery." [URL]
  5. Grand View Research. "Near-Infrared Fluorescence Imaging Market." [URL]

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