A Surgical View of Photodynamic Therapy in Oncology: A Review

Moghissi, K.; Dixon, Kate; Gibbins, Sally

doi:10.1055/s-0035-1565246

Cited by 41 publications

(12 citation statements)

References 137 publications

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“…The clinical use of fluorescent molecules dates back to the start of the twentieth century. Coined “Photodynamic Wirkung,” or photodynamic phenomenon, European scientists first described how to utilize these molecules to macroscopically label abnormal tissue (87). While initially a conceptual application, this methodology has driven numerous oncologic investigations of naturally derived fluorescent molecules.…”

Section: Discussionmentioning

confidence: 99%

Delta-Aminolevulinic Acid-Mediated Photodiagnoses in Surgical Oncology: A Historical Review of Clinical Trials

et al. 2019

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Fluorescence imaging is an emerging clinical technique for real-time intraoperative visualization of tumors and their boundaries. Though multiple fluorescent contrast agents are available in the basic sciences, few fluorescence agents are available for clinical use. Of the clinical fluorophores, delta aminolevulinic acid (5ALA) is unique for generating visible wavelength tumor-specific fluorescence. In 2017, 5ALA was FDA-approved for glioma surgery in the United States. Additionally, clinical studies suggest this agent may have utility in surgical subspecialties outside of neurosurgery. Data from dermatology, OB/GYN, urology, cardiothoracic surgery, and gastrointestinal surgery show 5ALA is helpful for intraoperative visualization of malignant tissues in multiple organ systems. This review summarizes data from English-language 5ALA clinical trials across surgical subspecialties. Imaging systems, routes of administration, dosing, efficacy, and related side effects are reviewed. We found that modified surgical microscopes and endoscopes are the preferred imaging devices. Systemic dosing across surgical specialties range between 5 and 30 mg/kg bodyweight. Multiple studies discussed potential for skin irritation with sun exposure, however this side effect is infrequently reported. Overall, 5ALA has shown high sensitivity for labeling malignant tissues and providing a means to visualize malignant tissue not apparent with standard operative light sources.

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Section: Discussionmentioning

confidence: 99%

Delta-Aminolevulinic Acid-Mediated Photodiagnoses in Surgical Oncology: A Historical Review of Clinical Trials

et al. 2019

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“…Recent emerging nanotechnology enables advanced PSs for PDT and PTT to enhance therapeutic performance with reduced adverse effects. However, most PDT and PTT with the state-of-the-art PSs have been applied to oncology to eliminate tumor cells [ 7 , 19 , 20 ]. On the other hand, phototherapy for non-oncologic applications has less appeared in both preclinical and clinical fields.…”

Section: Introductionmentioning

confidence: 99%

Non-Oncologic Applications of Nanomedicine-Based Phototherapy

Yoo

Ahn

et al. 2021

Biomedicines

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Phototherapy is widely applied to various human diseases. Nanomedicine-based phototherapy can be classified into photodynamic therapy (PDT) and photothermal therapy (PTT). Activated photosensitizer kills the target cells by generating radicals or reactive oxygen species in PDT while generating heat in PTT. Both PDT and PTT have been employed for treating various diseases, from preclinical to randomized controlled clinical trials. However, there are still hurdles to overcome before entering clinical practice. This review provides an overview of nanomedicine-based phototherapy, especially in non-oncologic diseases. Multiple clinical trials were undertaken to prove the therapeutic efficacy of PDT in dermatologic, ophthalmologic, cardiovascular, and dental diseases. Preclinical studies showed the feasibility of PDT in neurologic, gastrointestinal, respiratory, and musculoskeletal diseases. A few clinical studies of PTT were tried in atherosclerosis and dry eye syndrome. Although most studies have shown promising results, there have been limitations in specificity, targeting efficiency, and tissue penetration using phototherapy. Recently, nanomaterials have shown promising results to overcome these limitations. With advanced technology, nanomedicine-based phototherapy holds great potential for broader clinical practice.

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“…In recent decades, many different types and classes of photosensitisers have been investigated including Haematoporphyrin derivatives, Porfimer Sodium (Photofrin), Aminolevulinic acid (ALA), meta(tetrahydroxyphenyl)chlorin (mTHPC), mono-L-aspartyl chlorin e6 (NPe6) and Hypericin [7]. Clinically, PDT can be applied as a standalone method of treatment or in adjunct with surgery or chemotherapy [8,9].…”

Section: Introductionmentioning

confidence: 99%