A phase Ι study to evaluate the application of photocyanine using pharmacokinetic and pharmacodynamic analysis in patients with malignancy

PURPOSE

Photodynamic therapy (PDT) schedules are based on sensitiser dose, light dose, and drug-light interval. The aim of the phase Ι study was to choose optimal dose and drug-light interval for PDT with photocyanine using pharmacokinetics (PK) and pharmacodynamics (PD).

METHODS

Twenty-eight cancer patients were enrolled. In trial A, 12 patients received one of four ascending doses of photocyanine intravenously 24 h prior to 180-270 J/cm² illumination. 0.2 mg/kg dose was infused to ten patients 12-48 h prior to 120 J/cm² illumination in trial B. In trial C, 0.1 mg/kg dose was infused to six patients 6 or 12 h prior to 180-270 J/cm² illumination. Serum concentrations of photocyanine were measured, and simulations were performed to assess the effect of drug exposure in tissue on responses.

RESULTS

Analysis of photocyanine levels of patients indicated that the two-compartment model best fit the data. Simulations showed that the rates of the drug entering tissues and leaving tissues were equal at 8-12 h after injection. Patients experienced pain which was related to photocyanine serum levels, especially with serum levels above 2500 ng/ml. Fewer non-responders were observed at serum levels higher than 1000 ng/ml for illumination at least 12 h after administration.

CONCLUSION

It is the first report of human trials of photocyanine, and the results suggested that patients receive 180 J/cm² illumination about 20-30 min at serum concentrations of photocyanine between 1000 and 2500 ng/ml at least 10 h after administration.

A promising anticancer drug: a photosensitizer based on the porphyrin skeleton

Photodynamic therapy (PDT) is a minimally invasive combination of treatments that treat tumors and other diseases by using photosensitizers, light and oxygen to produce cytotoxic reactive oxygen species (ROS) inducing tumor cell apoptosis. Photosensitizers are the key part of PDT for clinical application and experimental research, and most of them are porphyrin compounds at present. Due to their unique affinity for tumor tissues, porphyrins are not only excellent photosensitizers, but also good carriers to transport other active drugs into tumor tissues, which can exert synergistic anticancer effects of PDT and chemotherapy. This article reviews the clinical development of porphyrin photosensitizers and the research status of porphyrin containing bioactive groups. Finally, future perspectives and the current challenges of photosensitizers based on the porphyrin skeleton are discussed.

Development of a quantitative method for four photocyanine isomers using differential ion mobility and tandem mass spectrometry and its application in a preliminary pharmacokinetics investigation

Photodynamic therapy (PDT) has been accepted as an alternative treatment for cancer, and its target specificity can be achieved by controlling the location at which light activates the photosensitizer. Photocyanine, a novel anticancer phthalocyanine-based photosensitizer, is a mixture of 4 cis-isomers of a series of synthetic products, and accordingly, it is essential to verify whether there are differences in pharmacokinetics among the four isomers for clinical application, which requires reliable analytical methods to measure the plasma concentrations of the four isomers. An efficient LC-MS/MS method coupled with differential mobility spectrometry (DMS) for the simultaneous quantification of the four photocyanine isomers in human plasma was developed and validated herein. This method had a limit of quantification of 10 ng mL^-1 for each isomer and showed stable and reproducible inter- and intra-day results. Use of this method in preliminary pharmacokinetic studies in patients with esophageal cancer showed that the exposure and distribution of the four isomers were different, which had not been found in previous studies. The present research revealed that DMS was an effective tool for isomeric quantitation and that LC-DMS-MS/MS presented robust and reliable in biomatrix analysis. The method significantly improved peak separation and sensitivity compared with that of other LC-MS-based methods.

Quantification of photocyanine in human serum by high-performance liquid chromatography-tandem mass spectrometry and its application in a pharmacokinetic study

Photocyanine is a novel anticancer drug. Its pharmacokinetic study in cancer patients is therefore very important for choosing doses, and dosing intervals in clinical application. A rapid, selective and sensitive high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was developed and validated for the determination of photocyanine in patient serum. Sample preparation involved one-step protein precipitation by adding methanol and N,N-dimethyl formamide to 0.1 mL serum. The detection was performed on a triple quadrupole tandem mass spectrometer operating in multiple reaction-monitoring (MRM) mode. Each sample was chromatographed within 7 min. Linear calibration curves were obtained for photocyanine at a concentration range of 20-2000 ng/mL (r > 0.995), with the lower limit of quantification (LLOQ) being 20 ng/mL. The intrabatch accuracy ranged from 101.98% to 107.54%, and the interbatch accuracy varied from 100.52% to 105.62%. Stability tests showed that photocyanine was stable throughout the analytical procedure. This study is the first to utilize the HPLC-MS/MS method for the pharmacokinetic study of photocyanine in six cancer patients who had received a single dose of photocyanine (0.1 mg/kg) administered intravenously.