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Alternative Tumor-Targeting Strategies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Given the need for a light source to activate this agent, not surprisingly, porphyrin sodium is mainly licensed for use in tumors that can be reached with laser endoscopy methods. It was first approved in Canada in 1993 for the treatment of bladder cancer, in Japan in 1994 for early stage lung cancer, and by the FDA in 1995, 1998, and 2003 for esophageal cancer, non-small cell lung cancer and Barrett’s esophagus, respectively. It is also used experimentally for other tumors of the skin and body cavities (e.g., stomach, colon, ovarian) that can be reached with flexible light sources. In the UK, porfimer sodium is recommended by NICE for the photodynamic therapy of non-small cell lung cancer and obstructing oesophageal cancer.
Oesophageal cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2014
Brian J. Haylock, Amir H. Montazeri
PDT uses a photosensitizing agent, porfimer sodium, in combination with endoscopic low-power laser exposure. Porfimer sodium is a haematoporphyrin derivative that accumulates in malignant tissue after intravenous injection, and the area is then exposed to an endoscopically placed low-power laser diffuser with monochrome light (630 nm), which initiates a photochemical reaction that results in tumour necrosis. The malignant tissue can be repeatedly treated to provide optimal tissue ablation.
Chemical approaches for the enhancement of porphyrin skeleton-based photodynamic therapy
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2020
Yuyan Lin, Tao Zhou, Renren Bai, Yuanyuan Xie
As the population ages, the number of cancer cases and deaths worldwide is also rapidly growing1,2. With the continuous development of medicine, the treatment strategies for cancer are also constantly improving. Photodynamic therapy (PDT) has been considered a safer cancer therapy approach with fewer side effects3. In 1978, Dougherty first applied this technique to gastrointestinal cancer using hematoporphyrin (HPD)4,5. Clinical studies revealed that PDT has been increasingly utilised in therapy for solid tumours, including tumours of the brain, head and neck, skin, oesophagus, lung, gastrointestinal, bone, bladder, prostate, breast, cervix, and ovary and in basal cell carcinomas6,7. Porfimer sodium (Photofrin®, Figure 1) was the first photosensitiser (PS) approved worldwide for the treatment of cancer. It has no long-term side effects and can be used repeatedly without causing drug resistance8. As an effective combination therapeutic strategy, Photofrin® did not display serious toxicity. Moreover, the survival period of inoperable tumour patients was prolonged, and the quality of life improved9,10. However, patients still suffered several side effects during the treatment, including skin photosensitivity and metabolic disturbances10.
Advances in chlorin-based photodynamic therapy with nanoparticle delivery system for cancer treatment
Published in Expert Opinion on Drug Delivery, 2021
Lin Huang, Sajid Asghar, Ting Zhu, Panting Ye, Ziyi Hu, Zhipeng Chen, Yanyu Xiao
Porfimer sodium is indicated by PDA for the treatment of microinvasive endobronchial non-small-cell lung cancer. Palliative treatment of obstructive cancer with HpD or porfimer sodium PDT was safe and resulted in symptom relief in almost all patients [233–236]. Main side effects include cough, expectoration of necrotic debris, and dyspnea for a few days after PDT.
Trial watch: an update of clinical advances in photodynamic therapy and its immunoadjuvant properties for cancer treatment
Published in OncoImmunology, 2023
Mafalda Penetra, Luís G. Arnaut, Lígia C. Gomes-da-Silva
The multitude of therapies that these patients underwent makes it difficult to draw any conclusion about the benefits of combining PDT with ICBs. However, these cases do highlight the advantages of using multimodal combinations that incorporate multiple therapies in the treatment of advanced and recurrent cancer, even in elderly people. Therefore, clinical trials methodically designed to specifically evaluate the combination of PDT with ICBs are needed to determine the true benefit of such combinatorial approach. Our search in ClinicalTrial.org only identified seven relevant studies. Of these, two are currently underway at the Roswell Park Cancer Institute and are still recruiting patients. The study NCT03727061 enrolls patients with locally advanced or recurrent head and neck cancer (estimated n = 82). It aims to evaluate the safety and therapeutic effects of combining porfimer sodium-based PDT with standard therapy such as: chemotherapy (cisplatin or carboplatin and fluorouracil), targeted agents (cetuximab), or immunotherapy (nivolumab or pembrolizumab). Tumor illumination is performed 48 h after the administration of the photosensitizer by inserting fibers into the target tumors (interstitial PDT). Safety, objective response rate, progression free survival, overall survival, and changes in quality of life will be evaluated between patients receiving standard therapy alone and patient receiving standard therapy plus PDT. This study also aimed to investigate the relationship between the response rate and the levels of serum alkaline deoxyribonuclease (DNase) activity, a circulating biomarker, as well as immune markers. However, it is not specified which immune markers will be evaluated. The other study, NCT04836429, aims to evaluate if porfimer sodium-based PDT performed after Video-Assisted Thoracic Surgery (VATS) can be used to enhance the responses of subsequent treatment with immunotherapy targeting the PD1-PDL1 axis. Porfimer sodium is administered 24–48 h before of VATS, and tumor illumination is performed after tumor removal. This study targets patients (estimated n = 16) with non-small cell lung cancer with pleural disease that are under treatment with chemotherapy with no disease progression and with PDL1 expression < 50%. In addition to the objective response rate, progression-free survival and overall survival, this study also aims to evaluate changes in the immune phenotype of peripheral blood CD8+ T cells and in platelet-to-lymphocyte ratio.