Photodynamic Therapy for Actinic Keratoses

Kalisiak, Michal S.; Rao, Jaggi

doi:10.1016/j.det.2006.09.006

Cited by 22 publications

(8 citation statements)

References 31 publications

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“…Protoporphyrin IX appears to accumulate selectively in neoplastic tissue at levels up 10‐fold greater than in normal tissue 26 . Photoactivation of protoporphyrin IX through application of a light source produces cytotoxic free radicals that cause direct damage to cell membranes, organelles, and surrounding vasculature as well as activation of an inflammatory immune response leading to clearance of tumor cells 27,28 …”

Section: Current Nonsurgical Approaches: Pdt and Topical Therapiesmentioning

confidence: 99%

“…26 Photoactivation of protoporphyrin IX through application of a light source produces cytotoxic free radicals that cause direct damage to cell membranes, organelles, and surrounding vasculature as well as activation of an inflammatory immune response leading to clearance of tumor cells. 27,28 There is no standard protocol for PDT, and the choice of photosensitizer, incubation time, and light source and number of treatments have varied throughout published trials. MAL has greater lipophilicity than ALA and is thought to have increased penetration of the stratum corneum, but the clinical significance of this is unclear because both compounds appear to have efficacy across the same spectrum of disorders.…”

Section: Pdtmentioning

confidence: 99%

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Nonsurgical Treatment Modalities for Primary Cutaneous Malignancies

Tull

Nunley

Sengelmann

2008

Dermatologic Surgery

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Section: Current Nonsurgical Approaches: Pdt and Topical Therapiesmentioning

confidence: 99%

Section: Pdtmentioning

confidence: 99%

Nonsurgical Treatment Modalities for Primary Cutaneous Malignancies

Tull

Nunley

Sengelmann

2008

Dermatologic Surgery

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“…5-fluorouracil) are also effective, but are associated with undesirable side effects including dryness, erythema, pain, or edema [2, 3]. Alternatively, photodynamic therapy (PDT) is a light-based treatment modality [4] which does not induce scarring or cumulative toxicity, allowing repeated treatments to the same areas [5–8]. In general, ALA-PpIX PDT is effective vs. alternative treatment options [9], but results in incomplete responses in a substantial number of patients (i.e.…”

Section: Introductionmentioning

confidence: 99%

Pre-treatment protoporphyrin IX concentration in actinic keratosis lesions may be a predictive biomarker of response to aminolevulinic-acid based photodynamic therapy

Kanick

Davis

Zhao

et al. 2015

Photodiagnosis and Photodynamic Therapy

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Background Although Aminolevulinic Acid (ALA)-induced protoporphyrin IX (PpIX) photodynamic therapy (PDT) is an effective FDA-approved therapy for actinic keratosis (AK), a substantial fraction of patients (up to 25%) do not respond to treatment. This study examined the feasibility of using pre-treatment measurements of PpIX concentration in AK lesions to predict response of ALA-PpIX PDT. Methods A non-invasive fiber-optic fluorescence spectroscopy system was used to measure PpIX concentration in patients undergoing standard-of-care ALA-PDT for AK. All patients provided assessments of pain at the time of treatment (n=70), and a subset reported pain and erythema 48–76 hours after treatment (n=13). Results PpIX concentration was significantly higher in lesions of patients reporting high levels of pain (VAS score ≥ 5) immediately after treatment vs. patients reporting pain scores below VAS=5 (p<0.022) (n=70). However, pain was not an exclusive indicator of PpIX concentration as many patients with low PpIX concentration reported high pain. In a subpopulation of patients surveyed in the days after treatment (n=13), PpIX concentration measured on the day of treatment was uncorrelated with pain-reported immediately after treatment (r=0.17, p<0.57), but positive correlations were found between PpIX concentration and patient-reported pain (r=0.55, p < 0.051) and erythema (r=0.58, p < 0.039) in the 48–72 hr following treatment. Conclusions These data suggest that in vivo optical measurements of PpIX concentration acquired before light delivery may be an objective predictor of response to ALA-PpIX PDT. Identification of non-responding patients on the day of treatment could facilitate the use of interventions that may improve outcomes.

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“…Metvix is demethylated to ALA through the action of intracellular esterases once inside the target cell. The standard process of biochemical events associated with ALA then occurs (118). The depth of penetration of Metvix fluorescence in BCC lesions following a 3 h uptake has been shown to be up to 2 mm (119) compared to a 1 mm penetration depth of Levulan.…”

mentioning

confidence: 99%

Porphyrin and Nonporphyrin Photosensitizers in Oncology: Preclinical and Clinical Advances in Photodynamic Therapy

O’Connor

Gallagher

Byrne

2009

Photochem & Photobiology

1,079

789

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Photodynamic therapy (PDT) is now a well-recognized modality for the treatment of cancer. While PDT has developed progressively over the last century, great advances have been observed in the field in recent years. The concept of dual selectivity of PDT agents is now widely accepted due to the relative specificity and selectivity of PDT along with the absence of harmful side effects often encountered with chemotherapy or radiotherapy. Traditionally, porphyrin-based photosensitizers have dominated the PDT field but these first generation photosensitizers have several disadvantages, with poor light absorption and cutaneous photosensitivity being the predominant side effects. As a result, the requirement for new photosensitizers, including second generation porphyrins and porphyrin derivatives as well as third generation photosensitizers has arisen, with the aim of alleviating the problems encountered with first generation porphyrins and improving the efficacy of PDT. The investigation of nonporphyrin photosensitizers for the development of novel PDT agents has been considerably less extensive than porphyrin-based compounds; however, structural modification of nonporphyrin photosensitizers has allowed for manipulation of the photochemotherapeutic properties. The aim of this review is to provide an insight into PDT photosensitizers clinically approved for application in oncology, as well as those which show significant potential in ongoing preclinical studies.

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Photodynamic Therapy for Actinic Keratoses

Cited by 22 publications

References 31 publications

Nonsurgical Treatment Modalities for Primary Cutaneous Malignancies

Nonsurgical Treatment Modalities for Primary Cutaneous Malignancies

Pre-treatment protoporphyrin IX concentration in actinic keratosis lesions may be a predictive biomarker of response to aminolevulinic-acid based photodynamic therapy

Porphyrin and Nonporphyrin Photosensitizers in Oncology: Preclinical and Clinical Advances in Photodynamic Therapy

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