1
|
Nath S, Saad MA, Pigula M, Swain JW, Hasan T. Photoimmunotherapy of Ovarian Cancer: A Unique Niche in the Management of Advanced Disease. Cancers (Basel) 2019; 11:E1887. [PMID: 31783651 PMCID: PMC6966499 DOI: 10.3390/cancers11121887] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 02/03/2023] Open
Abstract
Ovarian cancer (OvCa) is the leading cause of gynecological cancer-related deaths in the United States, with five-year survival rates of 15-20% for stage III cancers and 5% for stage IV cancers. The standard of care for advanced OvCa involves surgical debulking of disseminated disease in the peritoneum followed by chemotherapy. Despite advances in treatment efficacy, the prognosis for advanced stage OvCa patients remains poor and the emergence of chemoresistant disease localized to the peritoneum is the primary cause of death. Therefore, a complementary modality that is agnostic to typical chemo- and radio-resistance mechanisms is urgently needed. Photodynamic therapy (PDT), a photochemistry-based process, is an ideal complement to standard treatments for residual disease. The confinement of the disease in the peritoneal cavity makes it amenable for regionally localized treatment with PDT. PDT involves photochemical generation of cytotoxic reactive molecular species (RMS) by non-toxic photosensitizers (PSs) following exposure to non-harmful visible light, leading to localized cell death. However, due to the complex topology of sensitive organs in the peritoneum, diffuse intra-abdominal PDT induces dose-limiting toxicities due to non-selective accumulation of PSs in both healthy and diseased tissue. In an effort to achieve selective damage to tumorous nodules, targeted PS formulations have shown promise to make PDT a feasible treatment modality in this setting. This targeted strategy involves chemical conjugation of PSs to antibodies, referred to as photoimmunoconjugates (PICs), to target OvCa specific molecular markers leading to enhanced therapeutic outcomes while reducing off-target toxicity. In light of promising results of pilot clinical studies and recent preclinical advances, this review provides the rationale and methodologies for PIC-based PDT, or photo-immunotherapy (PIT), in the context of OvCa management.
Collapse
Affiliation(s)
| | | | | | | | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (S.N.); (M.A.S.); (M.P.)
| |
Collapse
|
2
|
Liu Z, Li J, Jiang Y, Wang D. Multifunctional nanocapsules on a seesaw balancing sonodynamic and photodynamic therapies against superficial malignant tumors by effective immune-enhancement. Biomaterials 2019; 218:119251. [PMID: 31319284 DOI: 10.1016/j.biomaterials.2019.119251] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/23/2019] [Accepted: 06/05/2019] [Indexed: 01/08/2023]
Abstract
The effective strategy to treat superficial malignant tumors is challenging due to the complexed mechanisms for tumor growth inhibition. The proposed immune-enhancement and immune response activation pathways rely on the direct and massive implementation of therapeutic agents. In this manuscript, an alternative route has been developed to apply the multifunctional peptide amphiphile-Rose Bengal (RB) nanocapsules for noninvasive sonodynamic and photodynamic therapies in association with the targeted immune enhancement to tumor proliferation. The nanocapsules proved better RB loading capacity, comparable reactive oxygen species generation and improved B16 and HeLa cell killing capability. The proof-of-principle in-vivo nude mice therapy studies with routine blood examinations and cytokine analysis validated their effectiveness for tumor cell elimination, and a direct tumor vasculature damage for efficacious lesion necrosis, positive prognosis with minimized side-effects. This state-of-the-art strategy provides a promising route to merge tumor enhancement and tumor response activation methodologies, and is expected to be universalized for a broad spectra of cancer diseases.
Collapse
Affiliation(s)
- Zhe Liu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, 300072, Tianjin, China; Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, 300072, Tianjin, China.
| | - Jiaping Li
- Department of Ophthalmology, People's Hospital of Tongren, 554300, Tongren, Guizhou, China
| | - Yan Jiang
- Wenzhou Medical University, 325001, Wenzhou, Zhejiang, China
| | - Doudou Wang
- Wenzhou Medical University, 325001, Wenzhou, Zhejiang, China
| |
Collapse
|
3
|
Hutnick MA, Ahsanuddin S, Guan L, Lam M, Baron ED, Pokorski JK. PEGylated Dendrimers as Drug Delivery Vehicles for the Photosensitizer Silicon Phthalocyanine Pc 4 for Candidal Infections. Biomacromolecules 2017; 18:379-385. [DOI: 10.1021/acs.biomac.6b01436] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Melanie A. Hutnick
- Department
of Macromolecular Science and Engineering, Case Western Reserve University, 2100 Adelbert Road, Cleveland, Ohio 44106, United States
| | - Sayeeda Ahsanuddin
- Department
of Dermatology, Case Skin Disease Research Center, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio 44106, United States
| | - Linna Guan
- Department
of Dermatology, Case Skin Disease Research Center, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio 44106, United States
| | - Minh Lam
- Department
of Dermatology, Case Skin Disease Research Center, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio 44106, United States
| | - Elma D. Baron
- Department
of Dermatology, Case Skin Disease Research Center, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, Ohio 44106, United States
| | - Jonathan K. Pokorski
- Department
of Macromolecular Science and Engineering, Case Western Reserve University, 2100 Adelbert Road, Cleveland, Ohio 44106, United States
| |
Collapse
|
4
|
Elimination of primary tumours and control of metastasis with rationally designed bacteriochlorin photodynamic therapy regimens. Eur J Cancer 2015; 51:1822-30. [DOI: 10.1016/j.ejca.2015.06.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 02/09/2015] [Accepted: 06/15/2015] [Indexed: 12/22/2022]
|
5
|
Kolk A, Wolff KD, Smeets R, Kesting M, Hein R, Eckert AW. Melanotic and non-melanotic malignancies of the face and external ear - A review of current treatment concepts and future options. Cancer Treat Rev 2014; 40:819-37. [PMID: 24814015 DOI: 10.1016/j.ctrv.2014.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 04/01/2014] [Accepted: 04/05/2014] [Indexed: 12/11/2022]
Abstract
Skin has the highest incidence and variety of tumors of all organs. Its structure is of great complexity, and every component has the potential to originate a skin neoplasm (SN). Because of its exposed nature, skin is vulnerable to carcinogenic stimuli such as UV radiation. Various entities can cause SN. Nonmelanotic skin cancers (NMSC) are the most common of all cancers, with over one million cases diagnosed annually in the US. Basal cell carcinoma (BCC) accounts for approximately 80% of all NMSC, most of the remaining 20% being squamous cell carcinoma (SCC). The skin of the head and neck is the most common site for tumors, accounting for more than 80% of all NMSC. BCC, SCC, and malignant melanomas (MM) represent 85-90% of all SN. Merkel cell tumors (MCC), lymphoepithelioma-like carcinomas of the skin (LELCS), dermato-fibro-sarcomas, leiomyosarkomas, and Kaposi-sarcomas are less frequent in the facial skin region and the external ear. Based on data from the German Federal Cancer Registry (2003/2004), 140,000 people in Germany were affected by SN (100,000 BCC, 22,000 SCC, 22,000 MM). This number increases considerably if malignant precursors, such as actinic keratosis, are included. Each year, the frequency of SN diagnosis rises by 3-7%. Among all known malignant tumors, MM exhibits the highest rate of increase in incidence. In the past, SN was primarily diagnosed in people aged 50 years or older. However, recently, the risk for developing SN has shifted, and younger people are also affected. Early diagnosis is significantly correlated with prognosis. Resection of SN creates defects that must be closed with local or microvascular flaps to avoid functional disturbing scar formation and deflection of the nose, eyelids, or lips. All therapeutic strategies for SN, the current standard for adjuvant and systemic treatment, and the management of the increasing number of patients under permanent blood thinner medication are described with regard to the treatment of SN.
Collapse
Affiliation(s)
- Andreas Kolk
- Department of Oral and Cranio-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Klaus-Dietrich Wolff
- Department of Oral and Cranio-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Marco Kesting
- Department of Oral and Cranio-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Rüdiger Hein
- Department of Dermatology and Allergology, Technische Universität München, Munich, Germany.
| | - Alexander W Eckert
- Department of Oral and Maxillofacial Plastic Surgery, Martin Luther University Halle-Wittenberg, Germany.
| |
Collapse
|
6
|
van Leeuwen-van Zaane F, van Driel PB, Gamm UA, Snoeks TJ, de Bruijn HS, van der Ploeg-van den Heuvel A, Löwik CW, Sterenborg HJ, Amelink A, Robinson DJ. Microscopic analysis of the localization of two chlorin-based photosensitizers in OSC19 tumors in the mouse oral cavity. Lasers Surg Med 2014; 46:224-34. [DOI: 10.1002/lsm.22220] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Floor van Leeuwen-van Zaane
- Department of Radiation Oncology; Center for Optical Diagnostics and Therapy; Postgraduate School Molecular Medicine; Erasmus MC; P.O. Box 2040 3000 CA Rotterdam The Netherlands
| | - Pieter B.A.A. van Driel
- Department of Radiology; Leiden University Medical Centre; P.O. Box 9600 2300 RC Leiden The Netherlands
| | - Ute A. Gamm
- Department of Radiation Oncology; Center for Optical Diagnostics and Therapy; Postgraduate School Molecular Medicine; Erasmus MC; P.O. Box 2040 3000 CA Rotterdam The Netherlands
| | - Thomas J.A. Snoeks
- Department of Radiology; Leiden University Medical Centre; P.O. Box 9600 2300 RC Leiden The Netherlands
| | - Henriëtte S. de Bruijn
- Department of Otolaryngology-Head and Neck Surgery; Center for Optical Diagnostics and Therapy; Erasmus MC; P.O. Box 2040 3000 CA Rotterdam The Netherlands
| | - Angelique van der Ploeg-van den Heuvel
- Department of Radiation Oncology; Center for Optical Diagnostics and Therapy; Postgraduate School Molecular Medicine; Erasmus MC; P.O. Box 2040 3000 CA Rotterdam The Netherlands
| | - Clemens W.G.M. Löwik
- Department of Radiology; Leiden University Medical Centre; P.O. Box 9600 2300 RC Leiden The Netherlands
| | - Henricus J.C.M. Sterenborg
- Department of Radiation Oncology; Center for Optical Diagnostics and Therapy; Postgraduate School Molecular Medicine; Erasmus MC; P.O. Box 2040 3000 CA Rotterdam The Netherlands
| | - Arjen Amelink
- Department of Radiation Oncology; Center for Optical Diagnostics and Therapy; Postgraduate School Molecular Medicine; Erasmus MC; P.O. Box 2040 3000 CA Rotterdam The Netherlands
| | - Dominic J. Robinson
- Department of Otolaryngology-Head and Neck Surgery; Center for Optical Diagnostics and Therapy; Erasmus MC; P.O. Box 2040 3000 CA Rotterdam The Netherlands
| |
Collapse
|
7
|
Saavedra R, Rocha LB, Dąbrowski JM, Arnaut LG. Modulation of Biodistribution, Pharmacokinetics, and Photosensitivity with the Delivery Vehicle of a Bacteriochlorin Photosensitizer for Photodynamic Therapy. ChemMedChem 2013; 9:390-8. [DOI: 10.1002/cmdc.201300449] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Indexed: 11/10/2022]
|
8
|
de Visscher SAHJ, Witjes MJH, van der Vegt B, de Bruijn HS, van der Ploeg-van den Heuvel A, Amelink A, Sterenborg HJCM, Roodenburg JLN, Robinson DJ. Localization of liposomal mTHPC formulations within normal epithelium, dysplastic tissue, and carcinoma of oral epithelium in the 4NQO-carcinogenesis rat model. Lasers Surg Med 2013; 45:668-78. [PMID: 24174342 DOI: 10.1002/lsm.22197] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Foslip and Fospeg are liposomal formulations of the photosensitizer mTHPC (Foscan), which is used for photodynamic therapy (PDT) of malignancies. Literature suggests that liposomal mTHPC formulations have better properties and increased tumor uptake compared to Foscan. To investigate this, we used the 4NQO-induced carcinogen model to compare the localization of the different mTHPC formulations within normal, precancerous, and cancerous tissue. In contrast to xenograft models, the 4NQO model closely mimics the carcinogenesis of human oral dysplasia. MATERIALS AND METHODS Fifty-four rats drank water with the carcinogen 4NQO. When oral examination revealed tumor, the rats received 0.15 mg/kg mTHPC (Foscan, Foslip, or Fospeg). At 2, 4, 8, 24, 48, or 96 hours after injection the rats were sacrificed. Oral tissue was sectioned for HE slides and for fluorescence confocal microscopy. The HE slides were scored on the severity of dysplasia by the epithelial atypia index (EAI). The calibrated fluorescence intensity per formulation or time point was correlated to EAI. RESULTS Fospeg showed higher mTHPC fluorescence in normal and tumor tissue compared to both Foscan and Foslip. Significant differences in fluorescence between tumor and normal tissue were found for all formulations. However, at 4, 8, and 24 hours only Fospeg showed a significant difference. The Pearson's correlation between EAI and mTHPC fluorescence proved weak for all formulations. CONCLUSION In our induced carcinogenesis model, Fospeg exhibited a tendency for higher fluorescence in normal and tumor tissue compared to Foslip and Foscan. In contrast to Foscan and Foslip, Fospeg showed significantly higher fluorescence in tumor versus normal tissue at earlier time points, suggesting a possible clinical benefit compared to Foscan. Low correlation between grade of dysplasia and mTHPC fluorescence was found.
Collapse
Affiliation(s)
- Sebastiaan A H J de Visscher
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Abdelghany S, Schmid D, Deacon J, Jaworski J, Fay F, McLaughlin KM, Gormley J, Burrows JF, Longley DB, Donnelly RF, Scott CJ. Enhanced antitumor activity of the photosensitizer meso-Tetra(N-methyl-4-pyridyl) porphine tetra tosylate through encapsulation in antibody-targeted chitosan/alginate nanoparticles. Biomacromolecules 2013; 14:302-10. [PMID: 23327610 PMCID: PMC3582313 DOI: 10.1021/bm301858a] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 01/16/2013] [Indexed: 11/29/2022]
Abstract
meso-Tetra(N-methyl-4-pyridyl) porphine tetra tosylate (TMP) is a photosensitizer that can be used in photodynamic therapy (PDT) to induce cell death through generation of reactive oxygen species in targeted tumor cells. However, TMP is highly hydrophilic, and therefore, its ability to accumulate intracellularly is limited. In this study, a strategy to improve TMP uptake into cells has been investigated by encapsulating the compound in a hydrogel-based chitosan/alginate nanoparticle formulation. Nanoparticles of 560 nm in diameter entrapping 9.1 μg of TMP per mg of formulation were produced and examined in cell-based assays. These particles were endocytosed into human colorectal carcinoma HCT116 cells and elicited a more potent photocytotoxic effect than free drug. Antibodies targeting death receptor 5 (DR5), a cell surface apoptosis-inducing receptor up-regulated in various types of cancer and found on HCT116 cells, were then conjugated onto the particles. The conjugated antibodies further enhanced uptake and cytotoxic potency of the nanoparticle. Taken together, these results show that antibody-conjugated chitosan/alginate nanoparticles significantly enhanced the therapeutic effectiveness of entrapped TMP. This novel approach provides a strategy for providing targeted site-specific delivery of TMP and other photosensitizer drugs to treat colorectal tumors using PDT.
Collapse
Affiliation(s)
- Sharif
M. Abdelghany
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Daniela Schmid
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Jill Deacon
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Jakub Jaworski
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Francois Fay
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Kirsty M. McLaughlin
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Julie
A. Gormley
- Fusion Antibodies
Ltd., Springbank Industrial Estate, Pembroke Loop Road,
Belfast, BT17 0QL, United Kingdom
| | - James F. Burrows
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Daniel B. Longley
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Ryan F. Donnelly
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Christopher J. Scott
- School of
Pharmacy, Centre for Cancer Research and Cell Biology, and Centre for Infection and Immunity, Queen’s University Belfast, 97
Lisburn Road, Belfast, BT9 7BL, United Kingdom
| |
Collapse
|
10
|
Qumseya BJ, David W, Wolfsen HC. Photodynamic Therapy for Barrett's Esophagus and Esophageal Carcinoma. Clin Endosc 2013; 46:30-7. [PMID: 23423151 PMCID: PMC3572348 DOI: 10.5946/ce.2013.46.1.30] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 01/14/2013] [Accepted: 01/14/2013] [Indexed: 01/14/2023] Open
Abstract
This paper reviews the use of photodynamic therapy (PDT) in patients with Barrett's esophagus and esophageal carcinoma. We describe the history of PDT, mechanics, photosensitizers for PDT in patients with esophageal disease. Finally, we discuss its utility and limitations in this setting.
Collapse
Affiliation(s)
- Bashar J Qumseya
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | | | | |
Collapse
|
11
|
Senge MO, Brandt JC. Temoporfin (Foscan®, 5,10,15,20-tetra(m-hydroxyphenyl)chlorin)--a second-generation photosensitizer. Photochem Photobiol 2011; 87:1240-96. [PMID: 21848905 DOI: 10.1111/j.1751-1097.2011.00986.x] [Citation(s) in RCA: 212] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This review traces the development and study of the second-generation photosensitizer 5,10,15,20-tetra(m-hydroxyphenyl)chlorin through to its acceptance and clinical use in modern photodynamic (cancer) therapy. The literature has been covered up to early 2011.
Collapse
Affiliation(s)
- Mathias O Senge
- Medicinal Chemistry, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, St. James's Hospital, Dublin 8, Ireland.
| | | |
Collapse
|
12
|
Celli JP, Spring BQ, Rizvi I, Evans CL, Samkoe KS, Verma S, Pogue BW, Hasan T. Imaging and photodynamic therapy: mechanisms, monitoring, and optimization. Chem Rev 2010; 110:2795-838. [PMID: 20353192 PMCID: PMC2896821 DOI: 10.1021/cr900300p] [Citation(s) in RCA: 1619] [Impact Index Per Article: 115.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Jonathan P Celli
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Gross SA, Wolfsen HC. The role of photodynamic therapy in the esophagus. Gastrointest Endosc Clin N Am 2010; 20:35-53, vi. [PMID: 19951793 DOI: 10.1016/j.giec.2009.07.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Photodynamic therapy (PDT) is a drug and device therapy using photosensitizer drugs activated by laser light for mucosal ablation. Porfimer sodium PDT has been used extensively with proven long-term efficacy and durability for the ablation of Barrett esophagus and high-grade dysplasia. and early esophageal adenocarcinoma. However, continued use is hampered by an associated stricture risk and prolonged photosensitivity (4-6 weeks). Promising single-center European studies using other forms of PDT, such as aminolevulinic acid PDT, have not been replicated elsewhere, limiting the widespread use of other forms of PDT. Future use of PDT in esophageal disease depends on the development of improved dosimetry and patient selection to optimize treatment outcomes, while minimizing adverse events and complications.
Collapse
Affiliation(s)
- Seth A Gross
- Division of Gastroenterology, Norwalk Hospital, Norwalk, CT 06856, USA
| | | |
Collapse
|
14
|
Wang KKH, Mitra S, Foster TH. Photodynamic dose does not correlate with long-term tumor response to mTHPC-PDT performed at several drug-light intervals. Med Phys 2008; 35:3518-26. [PMID: 18777912 DOI: 10.1118/1.2952360] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Meso-tetra-hydroxyphenyl-chlorin (mTHPC, Foscan), a promising photosensitizer for photodynamic therapy (PDT), is approved in Europe for the palliative treatment of head and neck cancer. Based on work in mice that investigated optimal tumor accumulation, clinical protocols with Foscan typically employ an interval of 96 h between systemic sensitizer administration and irradiation. However, recent studies in mouse tumor models have demonstrated significantly improved long-term tumor response when irradiation is performed at shorter drug-light intervals of 3 and 6 h. Using a previously published theoretical model of microscopic PDT dosimetry and informed by experimentally determined photophysical properties and intratumor sensitizer concentrations and distributions, we calculated photodynamic dose depositions following mTHPC-PDT for drug-light intervals of 3, 6, 24, and 96 h. Our results demonstrate that the singlet oxygen dose to the tumor volume does not track even qualitatively with tumor responses for these four drug-light intervals. Further, microscopic analysis of simulated singlet oxygen deposition shows that in no case do any subpopulations of tumor cells receive a threshold dose. Indeed, under the conditions of these simulations more than 90% of the tumor volume receives a dose that is approximately 20-fold lower than the threshold dose for mTHPC. Thus, in this evaluation of mTHPC-PDT at various drug-light intervals, any PDT dose metric that is proportional to singlet oxygen creation and/or deposition would fail to predict the tumor response. In situations like this one, other reporters of biological response to therapy would be necessary.
Collapse
Affiliation(s)
- Ken Kang-Hsin Wang
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | | | | |
Collapse
|
15
|
In vivo confocal fluorescence imaging of the intratumor distribution of the photosensitizer mono-L-aspartylchlorin-e6. Neoplasia 2008; 10:429-38. [PMID: 18472960 DOI: 10.1593/neo.08104] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 02/14/2008] [Accepted: 02/15/2008] [Indexed: 11/18/2022] Open
Abstract
We present an in vivo fluorescence microscopic evaluation of intratumor distribution of the photosensitizer mono-L-aspartylchlorin-e6 (NPe6) in an intradermal mouse EMT6 tumor model. Although the identification of favorable photophysical and pharmacological properties has led to the development of new photosensitizers in photodynamic therapy, their intratumor distribution kinetics have remained relatively understudied. In this study, we used confocal fluorescence microscopy to follow the transport of NPe6 in vivo after systemic administration through the tail vein. Labeling of vasculature using fluorophore-conjugated anti-CD31 antibodies allows visualization of the uptake of NPe6 in tumor and normal vessels and its partitioning kinetics into the adjacent parenchyma for 3 hours after injection. During the initial 60 minutes after injection, the drug is predominantly confined to the vasculature. Subsequently, it significantly redistributes throughout the extravascular regions with no discernable difference in its extravasation rate between tumor and normal tissues. Further, we investigate the sensitizer's altered intratumor distribution in response to photodynamic therapy irradiation and observe that treatment-induced changes in vessel permeability caused enhanced accumulation of NPe6 in the extravascular space. Our findings are of immediate clinical relevance and demonstrate the importance of an in vivo imaging approach to examine the dynamic process of intratumor drug distribution.
Collapse
|
16
|
Distribution of Free and Liposomal Doxorubicin After Isolated Lung Perfusion in a Sarcoma Model. Ann Thorac Surg 2008; 85:1225-32. [DOI: 10.1016/j.athoracsur.2007.12.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Revised: 12/03/2007] [Accepted: 12/10/2007] [Indexed: 11/21/2022]
|
17
|
Orthotopic animal models for oncologic photodynamic therapy and photodiagnosis. Photodiagnosis Photodyn Ther 2007; 4:230-6. [DOI: 10.1016/j.pdpdt.2007.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2007] [Revised: 09/19/2007] [Accepted: 09/26/2007] [Indexed: 02/08/2023]
|
18
|
Schouwink H, Ruevekamp M, Oppelaar H, Van Veen R, Baas P, Stewart FA. Photodynamic Therapy for Malignant Mesothelioma: Preclinical Studies for Optimization of Treatment Protocols¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2001)0730410ptfmmp2.0.co2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
19
|
Andrejevic Blant S, Ballini JP, Bergh H, Fontolliet C, Wagnières G, Monnier P. Time-dependent Biodistribution of Tetra(m-hydroxyphenyl)chlorin and Benzoporphyrin Derivative Monoacid Ring A in the Hamster Model: Comparative Fluorescence Microscopy Study. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2000)0710333tdbotm2.0.co2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
20
|
Borle F, Radu A, Monnier P, Bergh H, Wagnières G. Evaluation of the Photosensitizer Tookad® for Photodynamic Therapy on the Syrian Golden Hamster Cheek Pouch Model: Light Dose, Drug Dose and Drug-light Interval Effects¶. Photochem Photobiol 2007. [DOI: 10.1562/0031-8655(2003)0780377eotptf2.0.co2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
21
|
Abstract
We briefly review the history and principles of photodynamic therapy (PDT), especially as it is applied to choroidal neovascularization (CNV) in age-related macular degeneration (AMD). After a brief general history of PDT, we discuss the relationship between the physicochemical structure and photodynamic activity of the second-generation photosensitizers, such as those in current clinical use. We then discuss the basic photophysics of photosensitizer molecules, and describe the initial chemical reactions induced by activated sensitizers. We outline a novel method for screening photosensitizers to be used in treating CNV, as well as the complex biomolecular pathways modulated by PDT-induced oxidative stress and the vascular effects of PDT in solid tumors. The paper closes with a discussion of how all this information might be used to improve the selectivity and efficacy of clinically useful photosensitizers.
Collapse
Affiliation(s)
- H van den Bergh
- Swiss Federal Institute of Technology, Lausanne, Switzerland.
| |
Collapse
|
22
|
Krueger T, Kuemmerle A, Andrejevic-Blant S, Yan H, Pan Y, Ballini JP, Klepetko W, Decosterd LA, Stupp R, Ris HB. Antegrade Versus Retrograde Isolated Lung Perfusion: Doxorubicin Uptake and Distribution in a Sarcoma Model. Ann Thorac Surg 2006; 82:2024-30. [PMID: 17126104 DOI: 10.1016/j.athoracsur.2006.05.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2006] [Revised: 05/10/2006] [Accepted: 05/11/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Antegrade and retrograde doxorubicin-based isolated lung perfusions were compared in rodents bearing a sarcomatous tumor in the perfused lung. Inasmuch as these tumors derive their vascularization from the bronchial artery system, we hypothesized that retrograde isolated lung perfusion through the pulmonary vein might result in an improved tumor drug uptake. METHODS Single-pass antegrade (n = 9) and retrograde (n = 9) isolated left lung perfusions were performed with 100 microg of doxorubicin in Fischer rats 10 days after subpleural tumor cell injection. The perfusion, washout, and recirculation times were 20, 10, and 60 minutes, respectively, followed by harvesting of the lung. The doxorubicin concentration and compartmental distribution in the tumor and in normal parenchyma of each perfused lung were measured by high-pressure liquid chromatography (6 animals of each group) and fluorescence microscopy (3 animals of each group). RESULTS Doxorubicin concentration and pattern of doxorubicin-based fluorescence signaling were comparable for both perfusion techniques in normal lung tissue. Antegrade and retrograde isolated lung perfusion resulted in similar tumor drug uptake, which was lower than in normal lung parenchyma, and in weak and sporadic fluorescence signaling emerging from the tumor periphery and from blood vessels situated within the tumor tissue. CONCLUSIONS Retrograde isolated lung perfusion did not confer a better doxorubicin uptake in the tumor as compared with antegrade lung perfusion despite the fact that the tumor vascularization in this model is based on the bronchial artery circulation.
Collapse
Affiliation(s)
- Thorsten Krueger
- Division of Thoracic Surgery, Multidisciplinary Oncology Center, University Hospital, Lausanne, Switzerland.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Triesscheijn M, Ruevekamp M, Aalders M, Baas P, Stewart FA. Outcome of mTHPC mediated photodynamic therapy is primarily determined by the vascular response. Photochem Photobiol 2006; 81:1161-7. [PMID: 15934792 DOI: 10.1562/2005-04-04-ra-474] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have previously shown that the efficacy of photodynamic therapy (PDT) using the photosensitizer meso-tetra-hydroxyphenyl-chlorin (mTHPC) correlated with plasma drug levels at the time of illumination rather than drug levels in human tumor xenografts or mouse skin. These results suggested that vascular-mediated effects could be important determinants of PDT response in vivo. In the present study we further investigated the relationship between PDT response, mTHPC pharmacokinetics and the localization and extent of vascular damage induced in human squamous cell carcinoma xenografts (HNXOE). Plasma levels of mTHPC decreased exponentially with time after injection, whereas tumor drug levels remained maximal for at least 48 h. At 3 h after administration mTHPC was localized in the blood vessels, whereas at later times it was distributed throughout the whole tumor. Illumination at 3 h after mTHPC, which resulted in 100% long-term tumor cure, led to a marked reduction of vascular perfusion and increased tumor hypoxia at 1 h after treatment. Illumination at 48 h resulted in rapid regrowth of most tumors and only 10% cure. This protocol did not affect a significant decrease in vascular perfusion or increase in tumor hypoxia. These data show that optimal responses to mTHPC-mediated PDT were primarily dependent on the early vascular response, and that plasma drug levels at the time of illumination could predict this relationship.
Collapse
Affiliation(s)
- Martijn Triesscheijn
- Division of Experimental Therapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | | | | | | |
Collapse
|
24
|
Campbell SM, Gould DJ, Salter L, Clifford T, Curnow A. Photodynamic therapy using meta-tetrahydroxyphenylchlorin (Foscan) for the treatment of vulval intraepithelial neoplasia. Br J Dermatol 2005; 151:1076-80. [PMID: 15541088 DOI: 10.1111/j.1365-2133.2004.06197.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) has unique properties which make it suitable for the local treatment of superficial epithelial disorders; it has been suggested as a useful treatment for carcinoma in situ of the vulva. OBJECTIVES To evaluate the effect of the systemic photosensitizing agent meta-tetrahydroxyphenylchlorin (mTHPC or temoporfin; Foscan, Biolitec, Edinburgh, U.K.) in vulval intraepithelial neoplasia type III (VIN III). METHODS PDT using mTHPC was performed in six patients with VIN III. A dose of 0.1 mg kg(-1) body weight mTHPC was injected intravenously and the area of VIN irradiated 96 h later with 652-nm light from a diode laser. Patients were reviewed 1 week, 6 months and 2 years following treatment. RESULTS Patients experienced only minimal pain from the initial treatment but two patients subsequently developed severe pain at the treated site for up to 2 weeks following PDT. All patients developed oedema and slough formation at the treated site and one patient developed cellulitis. At 6 months two patients had developed small recurrences of VIN at the original site and one patient had an area of VIN at a new site. These were treated either with further PDT or with a small excision. At 2 years there was no recurrence of VIN at the original site in all patients reviewed. CONCLUSIONS This small case series demonstrates that mTHPC-PDT is a useful initial treatment for VIN III. It is relatively selective, shows good cosmesis and conserves form and function. This is a major advantage over surgery. Repeat treatments are also possible, which is important in a condition such as VIN, which tends to be multifocal. Systemic mTHPC-PDT appears to have an advantage over topical 5-aminolaevulinic acid-PDT as the photosensitizer is distributed widely in areas of disease and consequently identifies foci which may not be apparent clinically but become evident when illuminated.
Collapse
Affiliation(s)
- S M Campbell
- Cornwall Dermatology Research Project, Royal Cornwall Hospital, Truro, Cornwall TR1 3LJ, UK.
| | | | | | | | | |
Collapse
|
25
|
Kostenich G, Kimel S, Peled S, Orenstein A. Monitoring PDT-induced damage using spectrally resolved reflectance imaging of tissue oxygenation. Cancer Lett 2005; 219:169-75. [PMID: 15723716 DOI: 10.1016/j.canlet.2004.09.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2003] [Revised: 08/05/2004] [Accepted: 09/02/2004] [Indexed: 11/29/2022]
Abstract
Photodynamic therapy (PDT) with chlorin e6 (Chl) was monitored in vivo using vital microscopy and Fourier transform spectral imaging (FT-SI). Mammary C26 colon carcinoma, implanted intradermally in a mouse, was irradiated at 650 nm with various radiant exposures, 3 h after administration of 5 mg/kg Chl. The photodynamic response (PDR) in the skin flap with tumor was expressed as microcirculation disturbances (thrombi formation, multiple embolizations, arteriolar occlusion and venous stasis) and, dependent on the radiant exposure, was transient or permanent. These biological manifestations were accompanied by a change in hemoglobin (Hb)/oxyhemoglobin (HbO2) absorption spectra obtained in vivo by FT-SI. False-color mapping of hemoglobin oxygen saturation (OS) visualized the alteration of tissue oxygenation. The results demonstrate, for the first time, that FT-SI can serve as a sensitive non-invasive tool for OS monitoring of PDT effects.
Collapse
Affiliation(s)
- Genady Kostenich
- Advanced Technology Center, Sheba Medical Center, Tel Hashomer 52621, Israel.
| | | | | | | |
Collapse
|
26
|
Andrejevic-Blant S, Major A, Lüdicke F, Ballini JP, Wagnières G, van den Bergh H, Pelte MF. Time-dependent hexaminolaevulinate induced protoporphyrin IX distribution after topical application in patients with cervical intraepithelial neoplasia: A fluorescence microscopy study. Lasers Surg Med 2004; 35:276-83. [PMID: 15493027 DOI: 10.1002/lsm.20095] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES Compared to the conventional management of cervical intraepithelial neoplasia (CIN) the potential advantage of photodynamic therapy (PDT) for the treatment of cervical human papilloma virus (HPV)-related disease encompasses a minimal invasive procedure with reduced risk of profuse bleeding as a consequence of conization, and possibly more favorable long-term results avoiding cervical stenosis. At present little is known about the precise time-dependent distribution and histological localization of hexaminolaevulinate (HAL) induced protoporphyrin IX (PPIX) fluorescence in healthy tissue and in CIN. The aim of this study was to use ex vivo fluorescence microscopy to determine whether PPIX is selectively induced by neoplastic cells of the cervical epithelium at various times after topical application. STUDY DESIGN/MATERIALS AND METHODS Cold cream containing 0.5% HAL was applied by means of cervical cap over various periods of time. We analyzed 52 healthy cervical mucosa and 84 CINs. RESULTS At time delay 100 (+/-10) minutes, high epithelial fluorescence and a significant selectivity between epithelium and underlying lamina propria was found. By contrast, no significant difference between healthy and neoplastic tissues, or between low and high-grade epithelial dysplasia (P > or = 0.05), was observed at any time point. CONCLUSIONS Application of HAL 0.5% cream to the cervix induced selective fluorescence in epithelial cells. The optimal ratio with a homogeneous PPIX distribution was obtained after 100 ( +/- 10) minutes cream application, which should be evaluated further for PDT.
Collapse
|
27
|
Borle F, Radu A, Fontolliet C, van den Bergh H, Monnier P, Wagnières G. Selectivity of the photosensitiser Tookad for photodynamic therapy evaluated in the Syrian golden hamster cheek pouch tumour model. Br J Cancer 2004; 89:2320-6. [PMID: 14676813 PMCID: PMC2395293 DOI: 10.1038/sj.bjc.6601428] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The response to photodynamic therapy (PDT) with the photosensitiser (PS) Tookad® was measured in the Syrian hamster cheek pouch model on normal mucosae and chemically induced squamous cell carcinoma. This PS is a palladium-bacteriopheophorbide presenting absorption peaks at 538 and 762 nm. The light dose, drug dose and drug injection-light irradiation times (DLI), ranging between 100 and 300 J cm−2, 1–5 mg kg−1 and 10–240 min respectively, were varied and the response to PDT was analysed by staging the macroscopic response and by the histological examination of the sections of the irradiated cheek pouch. A fast time decay of the tissular response with drug dose of 1–5 mg kg−1 was observed for DLI ranging from 10 to 240 min and for light doses of 100–300 J cm−2 delivered at a light dose rate of 150 mW cm−2. A significantly higher level of tissular response was observed for squamous cell carcinoma compared to normal tissue. Nevertheless, the threshold level of the drug–light dose for a detectable response was not significantly different in the tumoral vs normal tissue. The highest response at the shortest DLIs and the absence of measurable response at DLI larger than 240 min at light dose of 300 J cm−2 and drug dose of 5 mg kg−1 reveals the predominantly vascular effect of Tookad®. This observation suggests that Tookad® could be effective in PDT of vascularised lesions.
Collapse
Affiliation(s)
- F Borle
- Institute of Environmental Engineering, Swiss Federal Institute of Technology (EPFL), CH-1015 Lausanne, Switzerland
| | - A Radu
- Department of Otolaryngology, Head and Neck Surgery, CHUV Hospital, CH-1011 Lausanne, Switzerland
| | - C Fontolliet
- Institute of Pathology, University of Lausanne, CH-1011 Lausanne, Switzerland
| | - H van den Bergh
- Institute of Environmental Engineering, Swiss Federal Institute of Technology (EPFL), CH-1015 Lausanne, Switzerland
| | - P Monnier
- Department of Otolaryngology, Head and Neck Surgery, CHUV Hospital, CH-1011 Lausanne, Switzerland
| | - G Wagnières
- Institute of Environmental Engineering, Swiss Federal Institute of Technology (EPFL), CH-1015 Lausanne, Switzerland
- Institute of Environmental Engineering, Swiss Federal Institute of Technology (EPFL), CH-1015 Lausanne, Switzerland. E-mail:
| |
Collapse
|
28
|
Borle F, Radu A, Monnier P, van den Bergh H, Wagnières G. Evaluation of the photosensitizer Tookad for photodynamic therapy on the Syrian golden hamster cheek pouch model: light dose, drug dose and drug-light interval effects. Photochem Photobiol 2004; 78:377-83. [PMID: 14626666 DOI: 10.1562/0031-8655(2003)078<0377:eotptf>2.0.co;2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have evaluated the efficacy of the new photosensitizer (PS) Tookad in photodynamic therapy (PDT) in vivo. This PS is a palladium-bacteriopheophorbide presenting absorption peaks at 762 and 538 nm. The light dose, drug dose and drug injection-light irradiation interval (DLI), ranging between 100 and 300 J/cm2, 1 and 5 mg/kg and from 10 to 240 min, respectively, were varied, and the response to PDT was analyzed by staging the macroscopic response and by the histological examination of the sections of the irradiated cheek pouch. The level of PDT response, macroscopically and histologically, shows a strong dependence on the DLI, light dose and drug dose at the applied conditions in the normal hamster cheek pouch. A decay of the tissular response with increasing DLI is observed corresponding to a time of half-maximum response ranging from 10 to 120 min, depending on drug dose and light dose. The tissues affected at the lowest doses are predominantly the vascularized diffuse connective tissue situated between the inner and outer striated muscle (SM) layers as well as these muscle layers themselves. The highest response at the shortest DLI and the absence of a measurable response at DLI longer than 240 min at 300 J/cm2 and drug dose of 5 mg/kg are characteristics of a predominantly vascular effect of this PS. This observation suggests that Tookad could be effective in PDT of vascularized lesions or pathologies associated with the proliferation of neovessels.
Collapse
Affiliation(s)
- François Borle
- Institute of Environmental Engineering, Swiss Federal Institute of Technology (EPFL), CH-1015 Lausanne, Switzerland.
| | | | | | | | | |
Collapse
|
29
|
Cramers P, Ruevekamp M, Oppelaar H, Dalesio O, Baas P, Stewart FA. Foscan uptake and tissue distribution in relation to photodynamic efficacy. Br J Cancer 2003; 88:283-90. [PMID: 12610515 PMCID: PMC2377038 DOI: 10.1038/sj.bjc.6600682] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Clinical photodynamic therapy (PDT) schedules are based on the assumption that optimum drug-light intervals are times at which there is a maximum differential between photosensitiser retention in the tumour and surrounding normal tissue. However, vascular-mediated effects contribute to tumour destruction by PDT; therefore, plasma sensitiser levels and endothelial cell drug exposure could also be important determinants of PDT response. The purpose of this study was to investigate the influence of tumour, tissue and plasma concentrations of the photosensitiser Foscan (meta-tetrahydroxyphenylchlorin, mTHPC) on PDT response. Groups of BalbC nude mice, bearing human mesothelioma xenografts (H-MESO1) were injected (i.v.) with a single dose of (14)C-labelled mTHPC, or with two doses, separated by 72 h. Drug levels in plasma, tumour and normal tissues were measured at 5 min to 120 h after drug administration. The PDT tumour and skin responses were evaluated by illuminating separate groups mice at intervals of 5 min to 120 h after injection of Foscan (nonlabelled). Drug levels in both tumour and skin increased during the first 24 h after a single injection, and remained almost constant for at least 120 h. The second injection produced a further, rapid increase in mTHPC levels in tumours and skin, with steady state being maintained from 20 min to 120 h. By contrast, PDT response of both tumours and skin were maximal for illumination at 1-3 h after drug, with very little response when illumination was given 48-120 h after drug. There was no significant correlation between tumour or skin drug level and PDT response. There was, however, a significant correlation between plasma drug levels and tumour or skin response, excluding an initial distribution time of 20 min. These studies demonstrate a pronounced disassociation between tumour drug levels and optimum drug-light intervals for PDT response with Foscan. We suggest that the PDT effect, in both tumours and normal tissues, is largely mediated via vascular damage and that the selectivity of PDT is not based on differential tumour drug uptake.
Collapse
Affiliation(s)
- P Cramers
- Experimental Therapy (H6), The Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - M Ruevekamp
- Experimental Therapy (H6), The Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - H Oppelaar
- Experimental Therapy (H6), The Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - O Dalesio
- Biometrics and Statistics, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, The Netherlands
| | - P Baas
- Medical Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, The Netherlands
| | - F A Stewart
- Experimental Therapy (H6), The Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Experimental Therapy (H6), The Netherlands Cancer Institute/Antoni van Leeuwenhoek Ziekenhuis, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. E-mail:
| |
Collapse
|
30
|
Coutier S, Bezdetnaya LN, Foster TH, Parache RM, Guillemin F. Effect of irradiation fluence rate on the efficacy of photodynamic therapy and tumor oxygenation in meta-tetra (hydroxyphenyl) chlorin (mTHPC)-sensitized HT29 xenografts in nude mice. Radiat Res 2002; 158:339-45. [PMID: 12175311 DOI: 10.1667/0033-7587(2002)158[0339:eoifro]2.0.co;2] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We present direct experimental evidence of the fluence-rate-dependent, radiation-induced variations in intratumor oxygen partial pressure (pO(2)) in HT29 human colon adenocarcinoma xenografts subjected to meta-tetra(hydroxyphenyl)chlorin (mTHPC)-based photodynamic therapy (PDT). The data establish a correlation between tumor oxygenation and treatment outcome. Tumor-bearing mice were injected with 0.3 mg/kg photosensitizer and subjected 72 h later to a 12 J/cm(2) red light dose administered at fluence rates of 5, 30, 90 and 160 mW/cm(2). A significant decrease in mean and median pO(2) was registered at approximately half of the total radiation fluence was delivered in tumors treated at rates of 160 and 90 mW/cm(2). Conversely, with the two lower fluence rates, intratumor pO(2) was maintained at levels comparable to those measured before illumination. Tumor oxygenation values registered shortly after every treatment protocol were at least equal to baseline levels, thus excluding the possibility of significant acute vessel damage during illumination. The tumor regrowth profile correlated with the pO(2) values monitored during irradiation. Tumors treated with fluence rates of 5 and 30 mW/cm(2) exhibited significantly longer tumor quadrupling times than those treated at 160 and 90 mW/cm(2). Improved tumor destruction could be expected by reducing the rate and the extent of oxygen depletion during meta-tetra(hydroxyphenyl)chlorin photodynamic therapy using low fluence rates.
Collapse
Affiliation(s)
- Stéphanie Coutier
- Unité de Recherche en Thérapie Photodynamique, Centre Alexis Vautrin, Vandoeuvre-les-Nancy, France
| | | | | | | | | |
Collapse
|
31
|
Andrejevic Blant S, Grosjean P, Ballini JP, Wagnières G, van den Bergh H, Fontolliet C, Monnier P. Localization of tetra(m-hydroxyphenyl)chlorin (Foscan) in human healthy tissues and squamous cell carcinomas of the upper aero-digestive tract, the esophagus and the bronchi: a fluorescence microscopy study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2001; 61:1-9. [PMID: 11485842 DOI: 10.1016/s1011-1344(01)00148-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
To date, little is known about precise time-dependent distribution and histological localization of tetra(m-hydroxyphenyl)chlorin (mTHPC) in human healthy tissues and squamous cell malignancies in the upper aero-digestive tract. A fluorescence microscopy study was performed on 50 healthy tissue biopsies and on 13 tumors (graded from Tis to T1 SCC) from 30 patients. Tissue samples were taken between 4 h and 11 days following injection of 0.15 mg/kg mTHPC. A fairly comparable distribution pattern in various tissues was observed over time in different patients. Vascular localization of mTHPC fluorescence predominates at a short delay, whereas the dye is essentially located in the tumoral and healthy mucosa after longer delays. A much lower uptake and retention of mTHPC fluorescence was noted in striated muscle and cartilage as compared to neoplastic lesions. No significant selectivity was found between healthy and tumoral mucosa. The obtained data are important to confirm drug-light interval that have been selected for effective PDT for early SCC malignancies while minimizing the risks of over- or under-treatment. The low fluorescence level in striated muscle provides the opportunity to develop interstitial PDT as a treatment modality for invasive SCC of unfavorable locations in the oral cavity or pharynx, such as the base of the tongue.
Collapse
Affiliation(s)
- S Andrejevic Blant
- Institute of Pathology University of Lausanne, CH-1011 Lausanne, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
32
|
Schouwink H, Ruevekamp M, Oppelaar H, van Veen R, Baas P, Stewart FA. Photodynamic therapy for malignant mesothelioma: preclinical studies for optimization of treatment protocols. Photochem Photobiol 2001; 73:410-7. [PMID: 11332037 DOI: 10.1562/0031-8655(2001)073<0410:ptfmmp>2.0.co;2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Effective photodynamic therapy (PDT) depends on the optimization of factors such as drug dose, drug-light interval, fluence rate and total light dose (or fluence). In addition sufficient oxygen has to be present for the photochemical reaction to occur. Oxygen deficits may arise during PDT if the photochemical reaction consumes oxygen more rapidly than it can be replenished, and this could limit the efficacy of PDT. In this study we investigated the influence of the drug-light interval, illumination-fluence rate and total fluence on PDT efficacy for the photosensitizer meta-tetrahydroxyphenylchlorin (mTHPC). The effect of increasing the oxygenation status of tumors during PDT was also investigated. PDT response was assessed from tumor-growth delay and from cures for human malignant mesothelioma xenografts grown in nude mice. Tumor-bearing mice were injected intravenously with 0.15 or 0.3 mg.kg-1 mTHPC, and after intervals of 24-120 h, the subcutaneous tumors were illuminated with laser light (652 nm) at fluence rates of 20, 100 or 200 mW.cm-2. Tumor response was strongly dependent on the drug-light interval. Illumination at 24 h after photosensitization was always significantly more effective than illumination at 72 or 120 h. For a drug-light interval of 24 h the tumor response increased with total fluence, but for longer drug-light intervals even high total fluences failed to produce a significant delay in tumor regrowth. No fluence-rate dependence of PDT response was demonstrated in these studies. Nicotinamide injection and carbogen breathing significantly increased tumor oxygenation and increased the tumor response for PDT schedules with illumination at 24 h after photosensitizer injection.
Collapse
Affiliation(s)
- H Schouwink
- Division of Experimental Therapy (H6), The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|
33
|
Lange N, Vaucher L, Marti A, Etter AL, Gerber P, van Den Bergh H, Jichlinski P, Kucera P. Routine experimental system for defining conditions used in photodynamic therapy and fluorescence photodetection of (non-) neoplastic epithelia. JOURNAL OF BIOMEDICAL OPTICS 2001; 6:151-159. [PMID: 11375724 DOI: 10.1117/1.1352751] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2000] [Revised: 01/12/2001] [Accepted: 01/12/2001] [Indexed: 05/23/2023]
Abstract
A common method to induce enhanced short-term endogenous porphyrin synthesis and accumulation in cell is the topical, systemic application of 5-aminolevulinic acid or one of its derivatives. This circumvents the intravenous administration of photosensitizers normally used for photodynamic therapy (PDT) of fluorescence photodetection. However, in the majority of potential medical indications, optimal conditions with respect to the porphyrin precursor or its pharmaceutical formulation have not yet been found. Due to ethical restrictions and animal right directives, the number of available test objects is limited. Hence, definition and use of nonanimal test methods are needed. Tissue and organ cultures are a promising approach in replacing cost intensive animal models in early stages of drug development. In this paper, we present a tissue culture, which can among others be used routinely to answer specific questions emerging in the field of photodynamic therapy and fluorescence photodetection. This technique uses mucosae excised from sheep paranasal sinuses or pig bladder, which is cultured under controlled conditions. It allows quasiquantitative testing of different protoporphyrin IX precursors with respect to dose-response curves and pharmacokinetics, as well as the evaluation of different incubation conditions and/or different drug formulations. Furthermore, this approach, when combined with the use of electron microscopy and fluorescence-based methods, can be used to quantitatively determine the therapeutic outcome following protoporphyrin IX-mediated PDT.
Collapse
Affiliation(s)
- N Lange
- Swiss Federal Institute of Technology Lausanne, Institute of Environmental Engineering, DGR-LPAS, CH-1015 Lausanne, Switzerland.
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Abstract
Photodynamic therapy (PDT) of malignant tumours is a new technique for treating cancers. After intravenous injection, a photosensitiser is selectively retained by the tumour cells so after time there is more sensitiser in the tumour than in the normal adjacent tissue. The photosensitiser must be able to absorb the wavelength of light being delivered to it, and the amount of light getting to the photosensitiser depends on the characteristics of the tissue it passes through. When exposed to light with the proper wavelength, the sensitiser produces an activated oxygen species, singlet oxygen, that oxidises critical elements of neoplastic cells. Because there is less sensitiser in the adjacent normal tissue, less reaction occurs to it. Since this is an entirely different process, the use of chemotherapy, ionising radiation or surgery does not preclude the use of PDT. Also, unlike ionising irradiation, repeated injections and treatments can be made indefinitely. Different molecules and atoms absorb different wavelengths of energy. Since the light energy must be absorbed to start the photochemical reaction, the absorption spectrum of the photosensitiser determines the wavelength used to initiate the reaction. However, this can be qualified by the tissue the light has to travel through to get to the photosensitiser. The photosensitiser porfimer sodium has a peak absorption in the area of 405 nm (blue-violet) and a much lower absorption peak at 630 nm (red). However, because the longer red wavelength penetrates tissue deeper than 405 nm, we use the red wavelength, usually delivered from a laser system. This permits coupling of the red light beam to quartz fibres which can then be used with modifications to treat external surface tumours, inserted interstitially directly into large tumours, passed though any endoscope to treat intraluminal tumours, or inserted behind the retina to treat tumours of the retina. Twenty years after the pioneering work of Dr. Thomas Doherty, the US Food and Drug Administration (FDA) has approved the use of porfimer sodium for photodynamic therapy of endobronchial and oesophageal tumours. Research continues towards approval for management of skin cancers and metastatic cutaneous and subcutaneous breast cancers. The realisation that one of the mechanisms of photodynamic therapy is thrombosis of vessels led to the development of verteporfin to treat macular degeneration. Multiple other areas are being investigated as well as new photosensitisers. Photodynamic therapy is an entirely new treatment modality and its development can be likened to that of the discovery of antibiotics. This is just the beginning, and its possible uses are only limited by the imagination.
Collapse
Affiliation(s)
- J S McCaughan
- Laser Medical Research Foundation and Grant Laser Center, Columbus, Ohio 43215, USA.
| |
Collapse
|
35
|
Zellweger M, Grosjean P, Monnier P, Bergh H, Wagnieres G. Rapid Communication: Stability of the Fluorescence Measurement of Foscan® in the Normal Human Oral Cavity as an Indicator of its Content in Early Cancers of the Esophagus and the Bronchi. Photochem Photobiol 1999. [DOI: 10.1111/j.1751-1097.1999.tb03335.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
36
|
Fielding DI, Buonaccorsi GA, MacRobert AJ, Hanby AM, Hetzel MR, Bown SG. Fine-needle interstitial photodynamic therapy of the lung parenchyma: photosensitizer distribution and morphologic effects of treatment. Chest 1999; 115:502-10. [PMID: 10027453 DOI: 10.1378/chest.115.2.502] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVE To look at the effect of interstitial photodynamic therapy (PDT) in normal lung parenchyma to assess its potential for treating localized, peripheral lung tumors. DESIGN Studies were performed on normal Wistar rats using the photosensitizer meso-tetrahydroxyphenyl chlorine. Drug distribution was measured by fluorescence microscopy on tissue sections. Light was delivered to the lungs via a single fiber inserted percutaneously under x-ray control and the PDT effect studied in animals killed at times up to 6 months later. RESULTS Fluorescence studies showed that the drug was initially distributed throughout the lung, but was later predominantly in the vasculature, bronchi, and macrophages. PDT produced sharply defined zones of hemorrhagic necrosis up to 12 mm in diameter that healed with regeneration of bronchial epithelium and local fibrosis. Different histologic effects were seen between drug light intervals of 1 and 3 days. Treatment was well tolerated, there was a low incidence of pneumothorax, and as long as the fiber tip was within the lung parenchyma, there was no damage to adjacent tissues. CONCLUSION Interstitial PDT produces zones of necrosis in normal lung that heal safely by a percutaneous technique without affecting adjacent areas of untreated lung. If the lesion size can be increased by using multiple fibers, this could be a promising new technique for treating localized, peripheral lung cancers in patients who are unfit for surgery.
Collapse
Affiliation(s)
- D I Fielding
- National Medical Laser Centre, Department of Surgery, University College London Medical School, UK
| | | | | | | | | | | |
Collapse
|
37
|
Andrejevic-Blant S, Woodtli A, Wagnieres G, Fontolliet C, van den Bergh H, Monnier P. Interstitial photodynamic therapy with tetra(m-hydroxyphenyl)chlorin: tumor versus striated muscle damage. Int J Radiat Oncol Biol Phys 1998; 42:403-12. [PMID: 9788423 DOI: 10.1016/s0360-3016(98)00221-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE The present study was initiated to determine the conditions under which a single photodynamic treatment would induce maximal damage to a tumor with no or at least minimal reversible damage to a normal striated muscle. METHODS AND MATERIALS The technique of interstitial light delivery was used after prior 0.5 mg/kg tetra(m-hydroxyphenyl)chlorin administration in a hamster model. After having estimated the threshold light doses required for minimal muscle damage, the same light doses were applied to squamous cell carcinomas to evaluate the efficiency of interstitial photodynamic therapy. Sixteen and 96 h after the injection, irradiation at 650 nm was performed on the thigh muscle of the left hind leg. The applied light doses ranged between 0.3-15 J and were delivered at an intensity of 44 mW per cm of diffuser length. RESULTS The threshold of muscle damage was obtained using light doses of 1.5-3 J at two drug-light intervals of 16 and 96 h, respectively. More than 85% of the tumor mass was destroyed when lesions were illuminated using these threshold conditions. In terms of immediate short-term tumor response, this means that for the given irradiation conditions, a relatively low threshold energy of only 1.5 or 3 J, depending on the drug-light interval, is sufficient to induce massive tumor destruction with minimal muscle damage. CONCLUSION These results have implications for evaluating interstitial PDT for squamous cell cancers in unfavorable localization in the oral cavity or pharynx, such as at the base of the tongue.
Collapse
Affiliation(s)
- S Andrejevic-Blant
- Department of Otolaryngology Head and Neck Surgery, CHUV Hospital, Lausanne, Switzerland.
| | | | | | | | | | | |
Collapse
|
38
|
Ris HB, Li Q, Krueger T, Lim CK, Reynolds B, Althaus U, Altermatt HJ. Photosensitizing effects of m-tetrahydroxyphenylchlorin on human tumor xenografts: correlation with sensitizer uptake, tumor doubling time and tumor histology. Int J Cancer 1998; 76:872-4. [PMID: 9626355 DOI: 10.1002/(sici)1097-0215(19980610)76:6<872::aid-ijc17>3.0.co;2-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The photodynamic effects of m-tetrahydroxyphenylchlorin (mTHPC) were assessed on human malignant mesothelioma, squamous cell carcinoma and adenocarcinoma xenografts grown in nude mice and were correlated with mTHPC uptake, histology and doubling time of the tumors. Non-thermal laser light was delivered to the tumor as surface radiation 4 days after intraperitoneal administration of 0.1 and 0.3 mg mTHPC/kg body weight, respectively. The extent of tumor necrosis was measured by histomorphometry. The mTHPC concentration in non-irradiated tumors was assessed by high-performance liquid chromatography (HPLC). The tumors were graded according to their doubling time and their vascular architecture as assessed by histology. The 0.1 mg/kg dose of mTHPC resulted in an equal uptake for all 3 tumor types but revealed a larger extent of photosensitized necrosis for adenocarcinoma, which displayed a delicate tumor stroma with numerous small capillary vessels, than for mesothelioma and squamous cell carcinoma, which were both poor in stroma and vessels. The 0.3 mg/kg dose of mTHPC resulted in a 2-fold higher tumor uptake for all 3 tumor types and in a larger extent of necrosis for mesothelioma and squamous cell carcinoma, but not for adenocarcinoma xenografts, compared with the lower drug dose. Our results demonstrate that different tumor xenografts respond differently to mTHPC-PDT for a given drug-light condition. In this setting, the photosensitizing effect was more closely related to the vascular architecture of the tumors than to the sensitizer uptake and doubling time of the different tumors
Collapse
Affiliation(s)
- H B Ris
- Department of Thoracic and Cardiovascular Surgery, University of Bern, Switzerland
| | | | | | | | | | | | | |
Collapse
|