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Recent advances in medical technology and endo-laparoscopic devices have enabled the treatment of gastrointestinal (GI) cancers to be minimally invasive through endo-laparoscopic photodynamic therapy (PDT). To achieve an efficient regional or endo-laparoscopic PDT, it is necessary to develop a highly target specific photosensitizer (PS) that can be easily treated to the lesion site with endo-laparoscopic device. Here, an ideal polymeric PS is demonstrated for effective endo-laparoscopic PDT. In the synthetic process, conventional PS (i.e., Chlorin e6, Ce6) is conjugated with an Aptamer (i.e., AS1411) targeting nucleolin (also called C23) overexpressed on the cancer cell membrane using a water-soluble polymeric linker (i.e., polyethylene glycol, PEG). The synthesized Aptamer-PEG-Ce6 could target nucleolinoverexpressing tumor cells efficiently and visualize the tumor tissues through optical and fluorescent imaging both in vitro and ex vivo, and effectively kills cancer cells under laser irradiation. Tumor staining with Aptamer-PEG-Ce6 is easily accomplished through endoscopic equipment within a few minutes. Furthermore, after laser irradiation, Aptamer-PEG-Ce6 is found to penetrate deeply into the tumor tissue and induce apoptosis of tumor cells. Taken together, the tumor-specific Aptamer-conjugated polymeric PS developed in this study has great potential as an ideal photomedicine for effective tumor treatment using endo-laparoscopic PDT.

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In article number https://doi.org/10.1002/adfm.201900084, Kun Na and co‐workers report a tumor‐specific aptamer‐conjugated polymeric photosensitizer (PS) to achieve an effective endo‐laparoscopic photodynamic therapy with minimal invasiveness for the treatment of gastrointestinal cancers. The tumor‐specific PS can not only accurately detect tumor tissue within a few minutes but also effectively treat the labeled tumor tissue by cytotoxic reactive oxygen species generation following laser irradiation.

Cholangiocarcinoma is a catastrophic tumor with a high mortality rate, for which surgery is the most reliable treatment. However, these tumors progress insidiously and are difficult to diagnose early. Most patients lack the opportunity to receive surgery due to the advanced disease stage at the time of the diagnosis, at which point only few alternative treatments are available. There is a need for more effective therapy to improve the survival or quality of life of these patients. The present case was a 73-year-old male who presented with jaundice and fatigue underwent CT imaging, in which a 3.5×4.0-cm low-attenuation mass was found in hepatic segment 4. Cholangiocarcinoma was diagnosed by cytological examination of the bile juice. A combination of CyberKnife radiosurgery and S-1 oral chemotherapy was performed. The patient was alive at a 8-month follow-up, and serial CT scans revealed a markedly regressed tumor. Therefore, we suggest that concurrent chemoradiation with the CyberKnife and S-1 is a treatment option for advanced cholangiocarcinoma. (Gut Liver 2010;4:103-105)