Vascular-targeted Photodynamic Therapy in Unilateral Low-risk Prostate Cancer in Germany: 2-yr Single-centre Experience in a Real-world Setting Compared with Radical Prostatectomy

Flegar, Luka; Buerk, Björn; Proschmann, Rick; Propping, Stefan; Groeben, Christer; Baunacke, Martin; Herout, Roman; Huber, Johannes; Thomas, Christian; Borkowetz, Angelika

doi:10.1016/j.euf.2021.01.018

Cited by 17 publications

(22 citation statements)

References 27 publications

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“…The confrontation with the actual individual clinical courses of one’s own patients typically reduces the initial euphoria. After FT patients require a strict follow-up with mpMRI and control biopsy [ 10 ]. Further, since the German S3 guidelines for PCa recommended FT only within clinical trials until the 2021 publication update, reimbursement by health insurance for some FT procedures might not have been covered [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…In total, 11 urology departments performed VTP-TOOKAD ® procedures in 2019 and 2 centers accomplished over 10 procedures. VTP in combination with TOOKAD ® soluble is available since 2018 for PCa treatment in Germany [ 10 ]. Azzouzi et al were able to show with the PCM 301 trial that VTP significantly reduces the incidence of aggressive PCa in follow-up examinations [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…First approaches in cryotherapy were described in the mid-1990s [ 9 ]. VTP with TOOKAD ® soluble has been approved by the European Medical Agency (EMA) in 2017 and has been clinically implemented in Germany since May 2018 [ 10 ]. TULSA is another new FT approach [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Alternative- and focal therapy trends for prostate cancer: a total population analysis of in-patient treatments in Germany from 2006 to 2019

et al. 2022

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Purpose Focal therapy (FT) offers an alternative approach for prostate cancer (PCa) treatment in selected patients. However, little is known on its actual establishment in health care reality. Patients and methods We defined FT as high-intensity focused ultrasound (HIFU), hyperthermia ablation, cryotherapy, transurethral ultrasound ablation (TULSA) or vascular-targeted photodynamic therapy (VTP) TOOKAD®. We analyzed the nationwide German hospital billing database for a PCa diagnosis in combination with FT. For analyses on the hospital level, we used the reimbursement.INFO tool based on hospitals’ quality reports. The study period was 2006 to 2019. Results We identified 23,677 cases of FT from 2006 to 2019. Considering all PCa cases with surgery, radiotherapy or FT, the share of FT was stable at 4%. The annual caseload of FT increased to a maximum of 2653 cases in 2008 (p < 0.001) and then decreased to 1182 cases in 2014 (p < 0.001). Since 2015, the cases of FT remained on a plateau around 1400 cases per year. The share of HIFU was stable at 92–96% from 2006 to 2017 and decreased thereafter to 75% in 2019 (p = 0.015). In 2019, VTP-TOOKAD® increased to 11.5% and TULSA to 6%. In 2006, 21% (62/299) of urological departments performed FT and 20 departments reached > 20 FT procedures. In 2019, 16% (58/368) of urological departments performed FT and 7 departments reached > 20 FT. In 2019, 25 urological departments offered FT other than HIFU: 5 centers hyperthermia ablation, 11 centers VTP TOOKAD®, 3 centers cryotherapy, 6 centers TULSA. Conclusion The FT development in Germany followed the Gartner hype cycle. While HIFU treatment is the most commonly performed FT, the share of newer FT modalities such as VTP-TOOKAD® and TULSA is remarkably increasing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Alternative- and focal therapy trends for prostate cancer: a total population analysis of in-patient treatments in Germany from 2006 to 2019

et al. 2022

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“…It has also been suggested to expose the tumor bed to light after tumor resection and curcumin administration [ 39 ]. Novel data point to the vascular targeted photodynamic therapy with WST11 (TOOKAD) as a novel treatment option for localized prostate cancer [ 40 , 41 ]. Overcoming the poor bioavailability of curcumin with light application is, therefore, a viable step towards implementing the clinical use of ingested curcumin.…”

Section: Discussionmentioning

confidence: 99%

Growth, Proliferation and Metastasis of Prostate Cancer Cells Is Blocked by Low-Dose Curcumin in Combination with Light Irradiation

Rutz

Benchellal

Kassabra

et al. 2021

IJMS

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Although anti-cancer properties of the natural compound curcumin have been reported, low absorption and rapid metabolisation limit clinical use. The present study investigated whether irradiation with visible light may enhance the inhibitory effects of low-dosed curcumin on prostate cancer cell growth, proliferation, and metastasis in vitro. DU145 and PC3 cells were incubated with low-dosed curcumin (0.1–0.4 µg/mL) and subsequently irradiated with 1.65 J/cm2 visible light for 5 min. Controls remained untreated and/or non-irradiated. Cell growth, proliferation, apoptosis, adhesion, and chemotaxis were evaluated, as was cell cycle regulating protein expression (CDK, Cyclins), and integrins of the α- and β-family. Curcumin or light alone did not cause any significant effects on tumor growth, proliferation, or metastasis. However, curcumin combined with light irradiation significantly suppressed tumor growth, adhesion, and migration. Phosphorylation of CDK1 decreased and expression of the counter-receptors cyclin A and B was diminished. Integrin α and β subtypes were also reduced, compared to controls. Irradiation distinctly enhances the anti-tumor potential of curcumin in vitro and may hold promise in treating prostate cancer.

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“…To date, PDT has been clinically approved for the treatment of a variety of solid cancers (e.g., lung, bladder, skin, and pancreatic tumors) 310 . Moreover, blood vascular‐targeted PDT has been approved in Europe for the treatment of low‐risk prostate cancer patients 311 and a number of Phase I/II/III clinical trials are ongoing to evaluate its efficacy for urologic, prostatic, and esophagogastric cancers (reviewed in 312). Interestingly, the potential of lymphatic‐targeted PDT is currently under preclinical evaluation and is based on the use of intra‐ or peritumoral injection of phototoxic compounds, such as verteporfin, that under liposomal formulation preferentially accumulate in lymphatics, and once activated react with the surrounding tissues, destroy lymphatic vessels and, if present, tumor cells within them (i.e., in transit lymphatic metastases) 313–315 .…”

Section: Therapeutic Perspectivesmentioning

confidence: 99%

The lymphatic vasculature: An active and dynamic player in cancer progression

Rezzola

Sigmund

Halin

et al. 2021

Medicinal Research Reviews

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The lymphatic vasculature has been widely described and explored for its key functions in fluid homeostasis and in the organization and modulation of the immune response. Besides transporting immune cells, lymphatic vessels play relevant roles in tumor growth and tumor cell dissemination. Cancer cells that have invaded into afferent lymphatics are propagated to tumor-draining lymph nodes (LNs), which represent an important hub for metastatic cell arrest and growth, immune modulation, and secondary dissemination to distant sites. In recent years many studies have reported new mechanisms by which the lymphatic vasculature affects cancer progression, ranging from induction of lymphangiogenesis to metastatic niche preconditioning or immune modulation. In this review, we provide an up-to-date description of lymphatic organization and function in peripheral tissues and in LNs and the This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Vascular-targeted Photodynamic Therapy in Unilateral Low-risk Prostate Cancer in Germany: 2-yr Single-centre Experience in a Real-world Setting Compared with Radical Prostatectomy

Cited by 17 publications

References 27 publications

Alternative- and focal therapy trends for prostate cancer: a total population analysis of in-patient treatments in Germany from 2006 to 2019

Alternative- and focal therapy trends for prostate cancer: a total population analysis of in-patient treatments in Germany from 2006 to 2019

Growth, Proliferation and Metastasis of Prostate Cancer Cells Is Blocked by Low-Dose Curcumin in Combination with Light Irradiation

The lymphatic vasculature: An active and dynamic player in cancer progression

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