Photodynamic Therapy for Lung Cancer and Malignant Pleural Mesothelioma

Abstract

Photodynamic therapy (PDT) is a form of non-ionizing radiation therapy that uses a drug, called a photosensitizer, combined with light to produce singlet oxygen (1O2) that can exert anti-cancer activity through apoptotic, necrotic, or autophagic tumor cell death. PDT is increasingly being used to treat thoracic malignancies. For early-stage non-small cell lung cancer (NSCLC), PDT is primarily employed as an endobronchial therapy to definitively treat endobronchial or roentgenographically occult tumors. Similarly, patients with multiple primary lung cancers may be definitively treated with PDT. For advanced or metastatic NSCLC and small cell lung cancer (SCLC), PDT is primarily employed to palliate symptoms from obstructing endobronchial lesions causing airway compromise or hemoptysis. PDT can be used in advanced NSCLC to attempt to increase operability or to reduce the extent of operation required, and selectively to treat pleural dissemination intraoperatively following macroscopically complete surgical resection. Intraoperative PDT can be safely combined with macroscopically complete surgical resection and other treatment modalities for malignant pleural mesothelioma (MPM) to improve local control and prolong survival. This report reviews the mechanism of and rationale for using PDT to treat thoracic malignancies, details prospective and major retrospectives studies of PDT to treat NSCLC, SCLC, and MPM, and describes improvements in and future roles and directions of PDT.

Macroscopic singlet oxygen modeling for dosimetry of Photofrin-mediated photodynamic therapy: an in-vivo study

“…4 Furthermore, off-label PDT applications as well as clinical trials have been performed. [5][6][7] PDT is a photochemical process combining the interactions among photosensitizer, light, and oxygen. During this process, the ground-state photosensitizer (S 0 ) is excited by light and converted to an excited state (S 1 ).…”

Pyrazolo[3,4-h]quinolines promising photosensitizing agents in the treatment of cancer

“…Generally, the controlled and targeted release of ROS by photosensitizer is crucial in PDT. Since its initial application, PDT continues to find increasing use in the treatment of certain types of malignancies including esophageal, head and neck, breast, prostate, bladder, skin and lung tumors [10,11].…”

The role of intracavitary therapies in the treatment of malignant pleural mesothelioma

“…All these effects are strongly dependent on many factors related to photosensitizing agent and the modalities of its administration (24,25). PDT in the treatment of MPM carries two main advantages; firstly, the cytotoxic effects have a relatively deep penetration in to the tissues; secondly, it has no cumulative toxic effect, so that it can be therefore administered several times and it can be associated to the others traditional systemic or loco-regional treatments such as chemotherapy or radiotherapy (7,25,26).…”