Photodynamic therapy for actinic keratosis: Is the European consensus protocol for daylight PDT superior to conventional protocol for Aktilite CL 128 PDT?

Vignion‐Dewalle, Anne‐Sophie; Baert, Gregory; Thecua, Elise; Vicentini, C.; Mortier, Laurent; Mordon, Serge

doi:10.1016/j.jphotobiol.2017.07.018

Cited by 10 publications

(11 citation statements)

References 41 publications

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“…As the damage induced by PDT depends on the amount of singlet oxygen generated per unit volume of tissue during treatment , local damage appears to be a suitable metric for protocol assessment. Defined as the integration of a function of both the spectral irradiance and the absorption spectrum of PpIX over the irradiation time , the local damage is computed by mathematical modeling for PDT of AK. This modeling takes into account the spatial and temporal variations in the absorption spectrum of PpIX during treatment: the absorption spectrum of PpIX is initialized depending on the incubation time and then changes in space and time along the irradiation time according to the biological clearance of PpIX, the conversion of MAL to PpIX and the photobleaching of PpIX.…”

Section: Methodsmentioning

confidence: 99%

“…Integrating this effective irradiance over the irradiation time gives the effective light dose, also known as the PpIX‐weighted light dose. Local damage, which is defined as the estimate of the total cumulative singlet oxygen molecules produced during treatment, is computed by mathematical modeling of PDT of AK, which we have published previously . Based on an iterative procedure, this modeling takes into account the spatial and temporal variations in the absorption spectrum of PpIX during treatment.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of 10 efficient protocols for photodynamic therapy of actinic keratosis: How relevant are effective light dose and local damage in predicting the complete response rate at 3 months?

et al. 2018

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of 10 efficient protocols for photodynamic therapy of actinic keratosis: How relevant are effective light dose and local damage in predicting the complete response rate at 3 months?

et al. 2018

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“…PDT could be a complementary option in combination with surgery and chemotherapy by targeting different mechanisms that can bypass tumor chemoresistance and chemosensitivity mechanisms. More precisely, PDT is a treatment technique based on the combination of photosensitizing molecules (PS), PS-specific excitation wavelength light, and intracellular oxygen, which must be in sufficient quantity [12]. The combination of these three factors will generate cytotoxic reactive oxygen species capable of inducing cancer cell death [13] and, more importantly, to close the tumor-associated vasculature and trigger the host immune system [14].…”

Section: Introductionmentioning

confidence: 99%

Photodynamic Therapy Using a New Folate Receptor-Targeted Photosensitizer on Peritoneal Ovarian Cancer Cells Induces the Release of Extracellular Vesicles with Immunoactivating Properties

Baydoun

Moralès

Frochot

et al. 2020

JCM

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Often discovered at an advanced stage, ovarian cancer progresses to peritoneal carcinoma, which corresponds to the invasion of the serosa by multiple tumor implants. The current treatment is based on the combination of chemotherapy and tumor cytoreduction surgery. Despite the progress and standardization of surgical techniques combined with effective chemotherapy, post-treatment recurrences affect more than 60% of women in remission. Photodynamic therapy (PDT) has been particularly indicated for the treatment of superficial lesions on large surfaces and appears to be a relevant candidate for the treatment of microscopic intraperitoneal lesions and non-visible lesions. However, the impact of this therapy on immune cells remains unclear. Hence, the objective of this study is to validate the efficacy of a new photosensitizer [pyropheophorbide a-polyethylene glycol-folic acid (PS)] on human ovarian cancer cells and to assess the impact of the secretome of PDT-treated cells on human peripheral blood mononuclear cells (PBMC). We show that PS, upon illumination, can induce cell death of different ovarian tumor cells. Furthermore, PDT using this new PS seems to favor activation of the immune response by inducing the secretion of effective cytokines and inhibiting the pro-inflammatory and immunosuppressive ones, as well as releasing extracellular vesicles (EVs) prone to activating immune cells. Finally, we show that PDT can activate CD4+ and CD8+ T cells, resulting in a potential immunostimulating process. The results of this pilot study therefore indicate that PS-PDT treatment may not only be effective in rapidly and directly destroying target tumor cells but also promote the activation of an effective immune response; notably, by EVs. These data thus open up good prospects for the treatment of micrometastases of intraperitoneal ovarian carcinosis which are currently inoperable.

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“…A mathematic model has demonstrated that daylight produced more local damage (more single oxygen radicals) that the conventional illumination with Aktilite ® even in cloudy days, but this accumulation has not demonstrated more efficacy in in vitro models or clinical trials, suggesting that the determinant factor for cytotoxicity is the total doses applied and not the irradiance or the PpIX accumulation . Moreover, a recent in vitro study has founded that half doses of red light, applied in half time, without changing irradiance are more effective in the induction of cell death of squamous cell carcinoma cells .…”

Section: Discussionmentioning

confidence: 99%

Split‐face study comparing conventional MAL photodynamic therapy in multiple actinic keratosis with complete time vs. half‐time red light LED conventional illumination

Fernández‐Guarino

Fonda‐Pascual

Gomez

et al. 2019

Acad Dermatol Venereol

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Background Conventional photodynamic therapy (PDT) with methylaminolevulinic acid (MAL) and daylight PDT have demonstrated similar efficacy in the treatment of actinic keratosis (AK). The reason for the use of daylight is to reduce pain during illumination but daylight has the limitation of the weather conditions. The difference in the doses of red light applied between these two methods suggests that an intermediate dose with red light conventional illumination could be effective in PDT of AK. Objective To compare the efficiency of conventional MAL‐PDT with half‐time conventional red light illumination in patients with multiple AK. Material and methods Adult patients with more than five symmetrically distributed AK were selected. After randomization, one area was treated with conventional PDT (Aktilite®, 630 nm, 37 J/cm2, 8 min), while the contralateral was illuminated half time (Aktilite®, 630 nm, 37 J/cm2, 4 min). Patients evaluated pain in each different side. Patients were evaluated at baseline, 3 and 6 months after PDT treatment by a blinded dermatologist. A questionnaire to be done at home 24 h after completing treatment was deliver to the patients to evaluate any side‐effects. Results A total of 774 lesions were treated, 385 with conventional PDT and 389 with half‐time PDT (P > 0.05). Conventional PDT was 85% of complete response of AK (327/385) at 3 months, and half‐time PDT was 82% (319/389). At 6 months, conventional PDT was 70% (268/385) of complete response and half‐time PDT was 65% (252/389). Pain during illumination was significantly lower in the VAS with the half‐time protocol with a mean of 5.59 (SD 1.48) vs. 6.41 (SD 1.66) in conventional PDT. No difference in adverse effects was found between protocols. Conclusion Conventional PDT with half‐time illumination in multiple actinic keratosis is as effective as complete time illumination and decreased pain significantly.

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Photodynamic therapy for actinic keratosis: Is the European consensus protocol for daylight PDT superior to conventional protocol for Aktilite CL 128 PDT?

Abstract: Results analysis shows that, even performed during an overcast day, the European consensus protocol for daylight PDT leads to higher PDT local damages than the efficient conventional protocol for Aktilite CL 128.

Cited by 10 publications

References 41 publications

Comparison of 10 efficient protocols for photodynamic therapy of actinic keratosis: How relevant are effective light dose and local damage in predicting the complete response rate at 3 months?

Comparison of 10 efficient protocols for photodynamic therapy of actinic keratosis: How relevant are effective light dose and local damage in predicting the complete response rate at 3 months?

Photodynamic Therapy Using a New Folate Receptor-Targeted Photosensitizer on Peritoneal Ovarian Cancer Cells Induces the Release of Extracellular Vesicles with Immunoactivating Properties

Split‐face study comparing conventional MAL photodynamic therapy in multiple actinic keratosis with complete time vs. half‐time red light LED conventional illumination

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