Transition metal complexes are of increasing interest as photosensitizers in photodynamic therapy (PDT) and, more recently, for photochemotherapy (PCT). In recent years, Ru (II) polypyridyl complexes have emerged as the most widely studied systems for both PDT and PCT. Their rich photochemical and photophysical properties derive from a variety of excited-state electronic configurations accessible with visible and near-infrared light, and these properties can be exploited for both energy-and electron-transfer processes that can yield highly potent oxygen-dependent and/or oxygen-independent photobiological activity. Selected examples highlight the use of rational design in coordination chemistry to control the lowest-energy triplet excited state configurations for eliciting a particular type of photoreactivity for PDT and/or PCT effects. These principles are also discussed in the context of the development of TLD1433, the first Ru(II)-based photosensitizer for PDT to enter a human clinical trial. The design of TLD1433 arose from a tumor-centered approach, as part of a complete PDT package that included the light component and the protocol for treating nonmuscle invasive bladder cancer. Briefly, this review summarizes *

Dosimetry for photodynamic therapy (PDT) is becoming increasingly complex as more factors are identified which may influence the effectiveness of a given treatment. The simple prescription of a PDT treatment in terms of the administered photosensitizer dose, the incident light and the drug-light time interval does not account for patient-to-patient variability in either the photosensitizer uptake, tissue optical properties or tissue oxygenation, nor for the interdependence of the photosensitizer-light-tissue factors. This interdependence is examined and the implications for developing adequate dosimetry for PDT are considered. The traditional dosimetric approach, measuring each dose factor independently, and termed here 'explicit dosimetry', may be contrasted with the recent trend to use photosensitizer photobleaching as an index of the effective delivered dose, termed here 'implicit dosimetry'. The advantages and limitations of each approach are discussed, and the need to understand the degree to which the photobleaching mechanism is linked, or 'coupled', to the photosensitizing mechanism is analysed. Finally, the influence of the tissue-response endpoints on the optimal dosimetry methods is considered.

Purpose: Anticancer drugs gain access to solid tumors via the circulatory system and must penetrate the tissue to kill cancer cells. Here, we study the distribution of doxorubicin in relation to blood vessels and regions of hypoxia in solid tumors of mice. Experimental Design:The distribution of doxorubicin was quantified by immunofluorescence in relation to blood vessels (recognized by CD31) of murine16C and EMT6 tumors and human prostate cancer PC-3 xenografts. Hypoxic regions were identified by injection of EF5. Results: The concentration of doxorubicin decreases exponentially with distance from tumor blood vessels, decreasing to half its perivascular concentration at a distance of about 40 to 50 Am, The mean distance from blood vessels to regions of hypoxia is 90 to 140 Am in these tumors. Many viable tumor cells are not exposed to detectable concentrations of drug following a single injection. Conclusions: Limited distribution of doxorubicin in solid tumors is an important and neglected cause of clinical resistance that is amenable to modification. The technique described here can be adapted to studying the distribution of other drugs within solid tumors and the effect of strategies to modify their distribution.