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Zhang J, Liu J, Huang Y, Yan L, Xu S, Zhang G, Pei L, Yu H, Zhu X, Han X. Current role of magnetic resonance imaging on assessing and monitoring the efficacy of phototherapy. Magn Reson Imaging 2024; 110:149-160. [PMID: 38621553 DOI: 10.1016/j.mri.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
Phototherapy, also known as photobiological therapy, is a non-invasive and highly effective physical treatment method. Its broad use in clinics has led to significant therapeutic results. Phototherapy parameters, such as intensity, wavelength, and duration, can be adjusted to create specific therapeutic effects for various medical conditions. Meanwhile, Magnetic Resonance Imaging (MRI), with its diverse imaging sequences and excellent soft-tissue contrast, provides a valuable tool to understand the therapeutic effects and mechanisms of phototherapy. This review explores the clinical applications of commonly used phototherapy techniques, gives a brief overview of how phototherapy impacts different diseases, and examines MRI's role in various phototherapeutic scenarios. We argue that MRI is crucial for precise targeting, treatment monitoring, and prognosis assessment in phototherapy. Future research and applications will focus on personalized diagnosis and monitoring of phototherapy, expanding its applications in treatment and exploring multimodal imaging technology to enhance diagnostic and therapeutic precision and effectiveness.
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Affiliation(s)
- Jiangong Zhang
- Department of Nuclear Medicine, The First people's Hospital of Yancheng, The Yancheng Clinical College of Xuzhou Medical University, Yancheng, PR China
| | - Jiahuan Liu
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Yang Huang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Linlin Yan
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Shufeng Xu
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Guozheng Zhang
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Lei Pei
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Huachen Yu
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, PR China
| | - Xisong Zhu
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China
| | - Xiaowei Han
- Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, PR China.
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Wu L, He C, Zhao T, Li T, Xu H, Wen J, Xu X, Gao L. Diagnosis and treatment status of inoperable locally advanced breast cancer and the application value of inorganic nanomaterials. J Nanobiotechnology 2024; 22:366. [PMID: 38918821 PMCID: PMC11197354 DOI: 10.1186/s12951-024-02644-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/16/2024] [Indexed: 06/27/2024] Open
Abstract
Locally advanced breast cancer (LABC) is a heterogeneous group of breast cancer that accounts for 10-30% of breast cancer cases. Despite the ongoing development of current treatment methods, LABC remains a severe and complex public health concern around the world, thus prompting the urgent requirement for innovative diagnosis and treatment strategies. The primary treatment challenges are inoperable clinical status and ineffective local control methods. With the rapid advancement of nanotechnology, inorganic nanoparticles (INPs) exhibit a potential application prospect in diagnosing and treating breast cancer. Due to the unique inherent characteristics of INPs, different functions can be performed via appropriate modifications and constructions, thus making them suitable for different imaging technology strategies and treatment schemes. INPs can improve the efficacy of conventional local radiotherapy treatment. In the face of inoperable LABC, INPs have proposed new local therapeutic methods and fostered the evolution of novel strategies such as photothermal and photodynamic therapy, magnetothermal therapy, sonodynamic therapy, and multifunctional inorganic nanoplatform. This article reviews the advances of INPs in local accurate imaging and breast cancer treatment and offers insights to overcome the existing clinical difficulties in LABC management.
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Affiliation(s)
- Linxuan Wu
- School of Intelligent Medicine, China Medical University, Shenyang, 110122, China
| | - Chuan He
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Tingting Zhao
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China
| | - Tianqi Li
- School of Intelligent Medicine, China Medical University, Shenyang, 110122, China
| | - Hefeng Xu
- School of Intelligent Medicine, China Medical University, Shenyang, 110122, China
| | - Jian Wen
- Department of Breast Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China.
| | - Xiaoqian Xu
- School of Intelligent Medicine, China Medical University, Shenyang, 110122, China.
| | - Lin Gao
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, 110022, China.
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3
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Kim HI, Lee SH, Shin SJ, Park JH, Yu JE, Lee SW, Yang SH, Pires L, Wilson BC. Phonozen-mediated photodynamic therapy comparing two wavelengths in a mouse model of peritoneal carcinomatosis. Photochem Photobiol Sci 2023; 22:2563-2572. [PMID: 37632684 DOI: 10.1007/s43630-023-00470-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/14/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND This study assessed the therapeutic efficacy of intraperitoneal photodynamic therapy (PDT) using photosensitizer activation at two different wavelengths, 405 and 664 nm, in a mouse model of peritoneal carcinomatosis. METHODS The dark and light cytotoxicity of chlorin e6-polyvinylpyrrolidone (Phonozen) were measured in vitro under 402 ± 14 and 670 ± 18 nm LED activation in bioluminescent human gastric cancer cells, MKN45-luc. Cell viability was measured at 6 h after irradiation using the PrestoBlue assay. Corresponding in vivo studies were performed in athymic nude mice by intraperitoneal injection of 1 × 106 MKN45-luc cells. PDT was performed 10 d after tumor induction and comprised intraperitoneal injection of Phonozen followed by light irradiation at 3 h, delivered by a diffusing-tip optical fiber placed in the peritoneal cavity and coupled to a 405 or 664 nm diode laser to deliver a total energy of 50 J (20 mice per cohort). Whole-body bioluminescence imaging was used to track the tumor burden after PDT out to 130 days, and 5 mice in each cohort were sacrificed at 4 h post treatment to measure the acute tumor necrosis. RESULTS Photosensitizer dose-dependent photocytotoxicity was higher in vitro at 405 than 664 nm. In vivo, PDT reduced the tumor growth rate at both wavelengths, with no statistically significant difference. There was substantial necrosis, and median survival was significantly prolonged at both wavelengths compared with controls (46 and 46 vs. 34 days). CONCLUSIONS Phonozen-mediated PDT results in significant cytotoxicity in vitro as well as tumor necrosis and prolonged survival in vivo following intraperitoneal light irradiation. Blue light was more photocytotoxic than red in vitro and had marginally higher efficacy in vivo.
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Affiliation(s)
- Hyoung-Il Kim
- Princess Margaret Cancer Research Tower, University Health Network, 15-314, 101 College Street, Toronto, ON, M5G 1L7, Canada
- Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
- Division of Upper Gastrointestinal Surgery, Gastric Cancer Center, Yonsei Cancer Center, Seoul, South Korea
- Yonsei-Dongsung Photodynamic Therapy Research Center, Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung-Ho Lee
- Yonsei-Dongsung Photodynamic Therapy Research Center, Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Su-Jin Shin
- Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong-Hyun Park
- Yonsei-Dongsung Photodynamic Therapy Research Center, Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, South Korea
- Department of Nano-Science and Technology, Graduate School of Convergence Science and Technology of Seoul National University, Seoul, South Korea
| | - Jae Eun Yu
- Yonsei-Dongsung Photodynamic Therapy Research Center, Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Won Lee
- Yonsei-Dongsung Photodynamic Therapy Research Center, Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Hee Yang
- Yonsei-Dongsung Photodynamic Therapy Research Center, Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Layla Pires
- Princess Margaret Cancer Research Tower, University Health Network, 15-314, 101 College Street, Toronto, ON, M5G 1L7, Canada
| | - Brian C Wilson
- Princess Margaret Cancer Research Tower, University Health Network, 15-314, 101 College Street, Toronto, ON, M5G 1L7, Canada.
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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Kim TE, Chang JE. Recent Studies in Photodynamic Therapy for Cancer Treatment: From Basic Research to Clinical Trials. Pharmaceutics 2023; 15:2257. [PMID: 37765226 PMCID: PMC10535460 DOI: 10.3390/pharmaceutics15092257] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Photodynamic therapy (PDT) is an emerging and less invasive treatment modality for various types of cancer. This review provides an overview of recent trends in PDT research, ranging from basic research to ongoing clinical trials, focusing on different cancer types. Lung cancer, head and neck cancer, non-melanoma skin cancer, prostate cancer, and breast cancer are discussed in this context. In lung cancer, porfimer sodium, chlorin e6, and verteporfin have shown promising results in preclinical studies and clinical trials. For head and neck cancer, PDT has demonstrated effectiveness as an adjuvant treatment after surgery. PDT with temoporfin, redaporfin, photochlor, and IR700 shows potential in early stage larynx cancer and recurrent head and neck carcinoma. Non-melanoma skin cancer has been effectively treated with PDT using methyl aminolevulinate and 5-aminolevulinic acid. In prostate cancer and breast cancer, PDT research is focused on developing targeted photosensitizers to improve tumor-specific uptake and treatment response. In conclusion, PDT continues to evolve as a promising cancer treatment strategy, with ongoing research spanning from fundamental investigations to clinical trials, exploring various photosensitizers and treatment combinations. This review sheds light on the recent advancements in PDT for cancer therapy and highlights its potential for personalized and targeted treatments.
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Affiliation(s)
| | - Ji-Eun Chang
- College of Pharmacy, Dongduk Women’s University, Seoul 02748, Republic of Korea
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Srivastava N, Usmani SS, Subbarayan R, Saini R, Pandey PK. Hypoxia: syndicating triple negative breast cancer against various therapeutic regimens. Front Oncol 2023; 13:1199105. [PMID: 37492478 PMCID: PMC10363988 DOI: 10.3389/fonc.2023.1199105] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/05/2023] [Indexed: 07/27/2023] Open
Abstract
Triple-negative breast cancer (TNBC) is one of the deadliest subtypes of breast cancer (BC) for its high aggressiveness, heterogeneity, and hypoxic nature. Based on biological and clinical observations the TNBC related mortality is very high worldwide. Emerging studies have clearly demonstrated that hypoxia regulates the critical metabolic, developmental, and survival pathways in TNBC, which include glycolysis and angiogenesis. Alterations to these pathways accelerate the cancer stem cells (CSCs) enrichment and immune escape, which further lead to tumor invasion, migration, and metastasis. Beside this, hypoxia also manipulates the epigenetic plasticity and DNA damage response (DDR) to syndicate TNBC survival and its progression. Hypoxia fundamentally creates the low oxygen condition responsible for the alteration in Hypoxia-Inducible Factor-1alpha (HIF-1α) signaling within the tumor microenvironment, allowing tumors to survive and making them resistant to various therapies. Therefore, there is an urgent need for society to establish target-based therapies that overcome the resistance and limitations of the current treatment plan for TNBC. In this review article, we have thoroughly discussed the plausible significance of HIF-1α as a target in various therapeutic regimens such as chemotherapy, radiotherapy, immunotherapy, anti-angiogenic therapy, adjuvant therapy photodynamic therapy, adoptive cell therapy, combination therapies, antibody drug conjugates and cancer vaccines. Further, we also reviewed here the intrinsic mechanism and existing issues in targeting HIF-1α while improvising the current therapeutic strategies. This review highlights and discusses the future perspectives and the major alternatives to overcome TNBC resistance by targeting hypoxia-induced signaling.
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Affiliation(s)
- Nityanand Srivastava
- Department of Cell Biology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Salman Sadullah Usmani
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Rajasekaran Subbarayan
- Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY, United States
- Research, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Educations, Chennai, India
| | - Rashmi Saini
- Department of Zoology, Gargi College, University of Delhi, New Delhi, India
| | - Pranav Kumar Pandey
- Dr. R.P. Centre for Opthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Penetra M, Arnaut LG, Gomes-da-Silva LC. Trial watch: an update of clinical advances in photodynamic therapy and its immunoadjuvant properties for cancer treatment. Oncoimmunology 2023; 12:2226535. [PMID: 37346450 PMCID: PMC10281486 DOI: 10.1080/2162402x.2023.2226535] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023] Open
Abstract
Photodynamic therapy (PDT) is a medical treatment used to target solid tumors, where the administration of a photosensitizing agent and light generate reactive oxygen species (ROS), thus resulting in strong oxidative stress that selectively damages the illuminated tissues. Several preclinical studies have demonstrated that PDT can prime the immune system to recognize and attack cancer cells throughout the body. However, there is still limited evidence of PDT-mediated anti-tumor immunity in clinical settings. In the last decade, several clinical trials on PDT for cancer treatment have been initiated, indicating that significant efforts are being made to improve current PDT protocols. However, most of these studies disregarded the immunological dimension of PDT. The immunomodulatory properties of PDT can be combined with standard therapy and/or emerging immunotherapies, such as immune checkpoint blockers (ICBs), to achieve better disease control. Combining PDT with immunotherapy has shown synergistic effects in some preclinical models. However, the value of this combination in patients is still unknown, as the first clinical trials evaluating the combination of PDT with ICBs are just being initiated. Overall, this Trial Watch provides a summary of recent clinical information on the immunomodulatory properties of PDT and ongoing clinical trials using PDT to treat cancer patients. It also discusses the future perspectives of PDT for oncological indications.
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Affiliation(s)
- Mafalda Penetra
- CQC - Coimbra Chemistry Center, Universidade de Coimbra, Coimbra, Portugal
| | - Luís G. Arnaut
- CQC - Coimbra Chemistry Center, Universidade de Coimbra, Coimbra, Portugal
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7
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Advanced techniques for performing photodynamic therapy in deep-seated tissues. Biomaterials 2022; 291:121875. [PMID: 36335717 DOI: 10.1016/j.biomaterials.2022.121875] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/07/2022] [Accepted: 10/23/2022] [Indexed: 11/23/2022]
Abstract
Photodynamic therapy (PDT) is a promising localized cancer treatment modality. It has been used successfully to treat a range of dermatological conditions with comparable efficacy to conventional treatments. However, some drawbacks limit the clinical utility of PDT in treating deep-seated tumors. Notably, the penetration limitation of UV and visible light, commonly applied to activate photosensitizers, makes PDT incompetent in treating deep-seated tumors. Development in light delivery technologies, especially fiber optics, led to improved clinical strategies for accessing deep tissues for irradiation. However, PDT efficacy issues remained partly due to light penetration limitations. In this review, we first summarized the current PDT applications for deep-seated tumor treatment. Then, the most recent progress in advanced techniques to overcome the light penetration limitation in PDT, including using functional nanomaterials that can either self-illuminate or be activated by near-infrared (NIR) light and X-rays as transducers, and implantable light delivery devices were discussed. Finally, current challenges and future opportunities of these technologies were discussed, which we hope may inspire the development of more effective techniques to enhance PDT efficacy against deep-seated tumors.
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8
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Menilli L, Milani C, Reddi E, Moret F. Overview of Nanoparticle-Based Approaches for the Combination of Photodynamic Therapy (PDT) and Chemotherapy at the Preclinical Stage. Cancers (Basel) 2022; 14:cancers14184462. [PMID: 36139623 PMCID: PMC9496990 DOI: 10.3390/cancers14184462] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The present review represents the outstanding and promising recent literature reports (2017–2022) on nanoparticle-based formulations developed for anticancer therapy with photodynamic therapy (PDT), photosensitizers, and chemotherapeutics. Besides brief descriptions of chemotherapeutics’ classification and of PDT mechanisms and limitations, several examples of nanosystems endowed with different responsiveness (e.g., acidic pH and reactive oxygen species) and peculiarity (e.g., tumor oxygenation capacity, active tumor targeting, and biomimetic features) are described, and for each drug combination, in vitro and in vivo results on preclinical cancer models are reported. Abstract The widespread diffusion of photodynamic therapy (PDT) as a clinical treatment for solid tumors is mainly limited by the patient’s adverse reaction (skin photosensivity), insufficient light penetration in deeply seated neoplastic lesions, unfavorable photosensitizers (PSs) biodistribution, and photokilling efficiency due to PS aggregation in biological environments. Despite this, recent preclinical studies reported on successful combinatorial regimes of PSs with chemotherapeutics obtained through the drugs encapsulation in multifunctional nanometric delivery systems. The aim of the present review deals with the punctual description of several nanosystems designed not only with the objective of co-transporting a PS and a chemodrug for combination therapy, but also with the goal of improving the therapeutic efficacy by facing the main critical issues of both therapies (side effects, scarce tumor oxygenation and light penetration, premature drug clearance, unspecific biodistribution, etc.). Therefore, particular attention is paid to the description of bio-responsive drugs and nanoparticles (NPs), targeted nanosystems, biomimetic approaches, and upconverting NPs, including analyzing the therapeutic efficacy of the proposed photo-chemotherapeutic regimens in in vitro and in vivo cancer models.
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Affiliation(s)
- Luca Menilli
- Department of Biology, University of Padova, 35100 Padova, Italy
| | - Celeste Milani
- Department of Biology, University of Padova, 35100 Padova, Italy
- Institute of Organic Synthesis and Photoreactivity, ISOF-CNR, 40129 Bologna, Italy
| | - Elena Reddi
- Department of Biology, University of Padova, 35100 Padova, Italy
- Correspondence: (E.R.); (F.M.)
| | - Francesca Moret
- Department of Biology, University of Padova, 35100 Padova, Italy
- Correspondence: (E.R.); (F.M.)
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McMullan P, White AB, Coker O, Opal S, McGee SA, Rogers G. Antimicrobial Efficacy of Continuous Low-Irradiance Phototherapy Against Multidrug-Resistant Organisms. Photobiomodul Photomed Laser Surg 2022; 40:613-621. [DOI: 10.1089/photob.2022.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Patrick McMullan
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Alexander B. White
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Oluwadara Coker
- Department of Translational Genomics and Precision Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Steven Opal
- Department of Medicine, Section of Infectious Diseases, Infectious Disease Division at Brown University Warren Alpert Medical School, Pawtucket, Rhode Island, USA
| | - Shayan A. McGee
- Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire
| | - Gary Rogers
- Departments of Surgery and Dermatology, Tufts University School of Medicine, Beverly, Massachusetts, USA
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Kaneko K, Acharya CR, Nagata H, Yang X, Hartman ZC, Hobeika A, Hughes PF, Haystead TAJ, Morse MA, Lyerly HK, Osada T. Combination of a novel heat shock protein 90-targeted photodynamic therapy with PD-1/PD-L1 blockade induces potent systemic antitumor efficacy and abscopal effect against breast cancers. J Immunother Cancer 2022; 10:jitc-2022-004793. [PMID: 36171008 PMCID: PMC9528636 DOI: 10.1136/jitc-2022-004793] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND We previously demonstrated potent antitumor activity against human breast cancer xenografts using photodynamic therapy (PDT) targeting a novel tumor-specific photosensitizer (HS201), which binds heat shock protein 90 (HS201-PDT). However, induction of systemic antitumor immunity by HS201-PDT alone or by the combination strategy with immune checkpoint blockade has yet to be determined. METHODS Using unilateral and bilateral implantation models of syngeneic breast tumors (E0771, MM3MG-HER2, and JC-HER3) in mice, we assessed whether HS201-PDT could induce local and systemic antitumor immunity. In an attempt to achieve a stronger abscopal effect for distant tumors, the combination strategy with anti-PD-L1 antibody was tested. Tumor-infiltrating leukocytes were analyzed by single cell RNA-sequencing and receptor-ligand interactome analysis to characterize in more detailed the mechanisms of action of the treatment and key signaling pathways involved. RESULTS HS201-PDT demonstrated greater tumor control and survival in immune competent mice than in immunocompromised mice, suggesting the role of induced antitumor immunity; however, survival was modest and an abscopal effect on distant implanted tumor was weak. A combination of HS201-PDT with anti-PD-L1 antibody demonstrated the greatest antigen-specific immune response, tumor growth suppression, prolonged mouse survival time and abscopal effect. The most significant increase of intratumoral, activated CD8+T cells and decrease of exhausted CD8+T cells occurred following combination treatment compared with HS201-PDT monotherapy. Receptor-ligand interactome analysis showed marked enhancement of several pathways, such as CXCL, GALECTIN, GITRL, PECAM1 and NOTCH, associated with CD8+T cell activation in the combination group. Notably, the expression of the CXCR3 gene signature was the highest in the combination group, possibly explaining the enhanced tumor infiltration by T cells. CONCLUSIONS The increased antitumor activity and upregulated CXCR3 gene signature induced by the combination of anti-PD-L1 antibody with HS201-PDT warrants the clinical testing of HS201-PDT combined with PD-1/PD-L1 blockade in patients with breast cancer, and the use of the CXCR3 gene signature as a biomarker.
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Affiliation(s)
- Kensuke Kaneko
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Chaitanya R Acharya
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Hiroshi Nagata
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Xiao Yang
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | | | - Amy Hobeika
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Philip F Hughes
- Department of Pharmacology and Cancer Biology, Duke University, Durham, North Carolina, USA
| | - Timothy A J Haystead
- Department of Pharmacology and Cancer Biology, Duke University, Durham, North Carolina, USA
| | - Michael A Morse
- Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Herbert Kim Lyerly
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Takuya Osada
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
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Watanabe T, Nishio Y, Yamamoto Y, Shimizu T, Li XK, Okita H, Kuroda T. Photodynamic therapy with 5-aminolevulinic acid: A new diagnostic, therapeutic, and surgical aid for neuroblastoma. J Pediatr Surg 2022; 57:1281-1285. [PMID: 35396087 DOI: 10.1016/j.jpedsurg.2022.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND 5-Aminolevulinic acid (ALA)-based photodynamic therapy (PDT) is widely used in cancer therapy because of the tumor-specific accumulation of photosensitizing protoporphyrin IX (PpIX). We aimed to assess the susceptibility of human neuroblastoma cell lines to ALA-PDT and determine the mechanism of PDT. METHODS We used four human neuroblastoma cell lines (GOTO, NB9, IMR32, and NB1) and a gastric cancer cell line (MKN45) as a positive control. Cells were treated with increasing concentrations of ALA, and the ALA-induced production of PpIX in tumor cells was quantified using fluorescence spectrophotometry. PDT photocytotoxicity was measured by exposing the cells to a 630-nm irradiation for 10 min, and apoptotic cells stained with phosphatidylserine (PS) and propidium iodide (PI) were detected through flow cytometry. RESULTS ALA cytotoxicity was not observed in any cell line. The intracellular concentration of PpIX increased in an ALA dose-dependent manner, and intracellular fluorescence of PpIX increased in a time-dependent manner. The viability of NB-1 cells treated with 250 μM 5-ALA rapidly decreased to 5%. Photocytotoxicity was observed in the following order: NB1, IMR32, NB-9, and GOTO. Photocytotoxicity was positively correlated with intracellular PpIX concentrations. PS+/PI- cells increased up to 21% after 12 h, and PS+/PI+ cells accounted for 35% of all cells after 24 h, which suggests that ALA-PDT induced apoptotic cell death. CONCLUSION This study shows that neuroblastoma cell lines were susceptible to 5-ALA-PDT, resulting in persistent apoptotic cell death. LEVELS OF EVIDENCE N/A for basic study.
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Affiliation(s)
- Toshihiko Watanabe
- Division of Surgery, National Center for Child Health and Development, Tokyo Japan; Department of Pediatric Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
| | - Yoshiaki Nishio
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yuki Yamamoto
- Department of Pediatric Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Takahiro Shimizu
- Department of Pediatric Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Xiao-Kang Li
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hajime Okita
- Division of Diagnostic Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
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Roque Iii JA, Cole HD, Barrett PC, Lifshits LM, Hodges RO, Kim S, Deep G, Francés-Monerris A, Alberto ME, Cameron CG, McFarland SA. Intraligand Excited States Turn a Ruthenium Oligothiophene Complex into a Light-Triggered Ubertoxin with Anticancer Effects in Extreme Hypoxia. J Am Chem Soc 2022; 144:8317-8336. [PMID: 35482975 PMCID: PMC9098688 DOI: 10.1021/jacs.2c02475] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ru(II) complexes that undergo photosubstitution reactions from triplet metal-centered (3MC) excited states are of interest in photochemotherapy (PCT) due to their potential to produce cytotoxic effects in hypoxia. Dual-action systems that incorporate this stoichiometric mode to complement the oxygen-dependent photosensitization pathways that define photodynamic therapy (PDT) are poised to maintain antitumor activity regardless of the oxygenation status. Herein, we examine the way in which these two pathways influence photocytotoxicity in normoxia and in hypoxia using the [Ru(dmp)2(IP-nT)]2+ series (where dmp = 2,9-dimethyl-1,10-phenanthroline and IP-nT = imidazo[4,5-f][1,10]phenanthroline tethered to n = 0-4 thiophene rings) to switch the dominant excited state from the metal-based 3MC state in the case of Ru-phen-Ru-1T to the ligand-based 3ILCT state for Ru-3T and Ru-4T. Ru-phen-Ru-1T, having dominant 3MC states and the largest photosubstitution quantum yields, are inactive in both normoxia and hypoxia. Ru-3T and Ru-4T, with dominant 3IL/3ILCT states and long triplet lifetimes (τTA = 20-25 μs), have the poorest photosubstitution quantum yields, yet are extremely active. In the best instances, Ru-4T exhibit attomolar phototoxicity toward SKMEL28 cells in normoxia and picomolar in hypoxia, with phototherapeutic index values in normoxia of 105-1012 and 103-106 in hypoxia. While maximizing excited-state deactivation through photodissociative 3MC states did not result in bonafide dual-action PDT/PCT agents, the study has produced the most potent photosensitizer we know of to date. The extraordinary photosensitizing capacity of Ru-3T and Ru-4T may stem from a combination of very efficient 1O2 production and possibly complementary type I pathways via 3ILCT excited states.
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Affiliation(s)
- John A Roque Iii
- Department of Chemistry and Biochemistry, The University of Texas at Arlington, Arlington, Texas 76019-0065, United States.,Department of Chemistry and Biochemistry, The University of North Carolina at Greensboro, Greensboro, North Carolina 27402, United States
| | - Houston D Cole
- Department of Chemistry and Biochemistry, The University of Texas at Arlington, Arlington, Texas 76019-0065, United States
| | - Patrick C Barrett
- Department of Chemistry and Biochemistry, The University of North Carolina at Greensboro, Greensboro, North Carolina 27402, United States
| | - Liubov M Lifshits
- Department of Chemistry and Biochemistry, The University of Texas at Arlington, Arlington, Texas 76019-0065, United States
| | - Rachel O Hodges
- Department of Chemistry and Biochemistry, The University of North Carolina at Greensboro, Greensboro, North Carolina 27402, United States
| | - Susy Kim
- Department of Cancer Biology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157, United States
| | - Gagan Deep
- Department of Cancer Biology, Wake Forest School of Medicine, Winston Salem, North Carolina 27157, United States
| | | | - Marta E Alberto
- Dipartimento di Chimica e Tecnologie Chimiche, Università della Calabria, Arcavacata di Rende 87036, Italy
| | - Colin G Cameron
- Department of Chemistry and Biochemistry, The University of Texas at Arlington, Arlington, Texas 76019-0065, United States
| | - Sherri A McFarland
- Department of Chemistry and Biochemistry, The University of Texas at Arlington, Arlington, Texas 76019-0065, United States
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13
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Huang S, Parekh V, Waisman J, Jones V, Yuan Y, Vora N, Li R, Jung J, Kruper L, Abdulla F, Fong Y, Li WY. Cutaneous metastasectomy: Is there a role in breast cancer? A systematic review and overview of current treatment modalities. J Surg Oncol 2022; 126:217-238. [PMID: 35389520 PMCID: PMC9545220 DOI: 10.1002/jso.26870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/03/2022] [Accepted: 03/13/2022] [Indexed: 12/21/2022]
Abstract
Cutaneous metastases (CM) are neoplastic lesions involving the dermis or subcutaneous tissues, originating from another primary tumor. Breast cancer is commonest primary solid tumor, representing 24%–50% of CM patients. There is no “standard of care” on management. In particular, the role of surgery in the treatment of cutaneous metastases from breast carcinoma (CMBC) remains controversial. This systematic review evaluates the role of cutaneous metastasectomy in breast cancer and provides an overview of existing treatment types.
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Affiliation(s)
- Samantha Huang
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Vishwas Parekh
- Department of Pathology, City of Hope, Duarte, California, USA
| | - James Waisman
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, California, USA
| | - Veronica Jones
- Division of Breast Surgery, City of Hope, Duarte, California, USA
| | - Yuan Yuan
- Department of Medical Oncology & Therapeutics Research, City of Hope, Duarte, California, USA
| | - Nayana Vora
- Department of Radiation Oncology, City of Hope, Duarte, California, USA
| | - Richard Li
- Department of Radiation Oncology, City of Hope, Duarte, California, USA
| | - Jae Jung
- Division of Derm-oncology, Norton Cancer Institute, Louisville, Kentucky, USA
| | - Laura Kruper
- Division of Breast Surgery, City of Hope, Duarte, California, USA
| | - Farah Abdulla
- Division of Dermatology, City of Hope, Duarte, California, USA
| | - Yuman Fong
- Department of Surgery, City of Hope, Duarte, California, USA
| | - Wai-Yee Li
- Division of Plastic Surgery, City of Hope, Duarte, California, USA
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14
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Nkune NW, Simelane NWN, Montaseri H, Abrahamse H. Photodynamic Therapy-Mediated Immune Responses in Three-Dimensional Tumor Models. Int J Mol Sci 2021; 22:12618. [PMID: 34884424 PMCID: PMC8657498 DOI: 10.3390/ijms222312618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 12/12/2022] Open
Abstract
Photodynamic therapy (PDT) is a promising non-invasive phototherapeutic approach for cancer therapy that can eliminate local tumor cells and produce systemic antitumor immune responses. In recent years, significant efforts have been made in developing strategies to further investigate the immune mechanisms triggered by PDT. The majority of in vitro experimental models still rely on the two-dimensional (2D) cell cultures that do not mimic a three-dimensional (3D) cellular environment in the human body, such as cellular heterogeneity, nutrient gradient, growth mechanisms, and the interaction between cells as well as the extracellular matrix (ECM) and therapeutic resistance to anticancer treatments. In addition, in vivo animal studies are highly expensive and time consuming, which may also show physiological discrepancies between animals and humans. In this sense, there is growing interest in the utilization of 3D tumor models, since they precisely mimic different features of solid tumors. This review summarizes the characteristics and techniques for 3D tumor model generation. Furthermore, we provide an overview of innate and adaptive immune responses induced by PDT in several in vitro and in vivo tumor models. Future perspectives are highlighted for further enhancing PDT immune responses as well as ideal experimental models for antitumor immune response studies.
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Affiliation(s)
| | | | | | - Heidi Abrahamse
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, P.O. Box 17011, Johannesburg 2028, South Africa; (N.W.N.); (N.W.N.S.); (H.M.)
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15
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Photodynamic Therapy Induced Cell Death Mechanisms in Breast Cancer. Int J Mol Sci 2021; 22:ijms221910506. [PMID: 34638847 PMCID: PMC8508861 DOI: 10.3390/ijms221910506] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/18/2021] [Accepted: 09/24/2021] [Indexed: 12/13/2022] Open
Abstract
Breast cancer is the second most common cancer globally and the pioneering cause of mortality among women. It usually begins from the ducts or lobules, referred to as ductal carcinoma in situ, or lobular carcinoma in situ. Age, mutations in Breast Cancer Gene 1 or 2 (BRCA1 or BRCA2) genes, and dense breast tissue are the highest risk factors. Current treatments are associated with various side effects, relapse, and a low quality of life. Although conventional treatments, such as surgery and chemotherapy, have been used for decades, their adverse side effects on normal cells and tissues pose a major weakness, which calls for a non-invasive treatment option. Photodynamic therapy (PDT) has proven to be a promising form of cancer therapy. It is less invasive, target-specific, and with reduced cytotoxicity to normal cells and tissues. It involves the use of a photosensitizer (PS) and light at a specific wavelength to produce reactive oxygen species. One of the reasons for the target specificity is associated with the dense vascularization of cancer tissues, which tends to increase the surface area for the PS uptake. Photosensitizers are light-sensitive molecules, which result in cancer cell destruction followed by light irradiation. Depending on the localization of the PS within the cancer cell, its destruction may be via apoptosis, necrosis, or autophagy. This review focuses on the breast cancer etiopathology and PDT-induced cell death mechanisms in breast cancer cells.
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Shanazarov N, Zinchenko S, Zhapparov E, Muratov N, Turzhanova D, Bilyalov A, Tashpulatov T. The Clinical Case of Successful Application of Photodynamic Therapy in the Skin Metastases Treatment of Breast Cancer. BIONANOSCIENCE 2021. [DOI: 10.1007/s12668-021-00907-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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17
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Algorri JF, Ochoa M, Roldán-Varona P, Rodríguez-Cobo L, López-Higuera JM. Light Technology for Efficient and Effective Photodynamic Therapy: A Critical Review. Cancers (Basel) 2021; 13:3484. [PMID: 34298707 PMCID: PMC8307713 DOI: 10.3390/cancers13143484] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/17/2021] [Accepted: 07/07/2021] [Indexed: 12/18/2022] Open
Abstract
Photodynamic therapy (PDT) is a cancer treatment with strong potential over well-established standard therapies in certain cases. Non-ionising radiation, localisation, possible repeated treatments, and stimulation of immunological response are some of the main beneficial features of PDT. Despite the great potential, its application remains challenging. Limited light penetration depth, non-ideal photosensitisers, complex dosimetry, and complicated implementations in the clinic are some limiting factors hindering the extended use of PDT. To surpass actual technological paradigms, radically new sources, light-based devices, advanced photosensitisers, measurement devices, and innovative application strategies are under extensive investigation. The main aim of this review is to highlight the advantages/pitfalls, technical challenges and opportunities of PDT, with a focus on technologies for light activation of photosensitisers, such as light sources, delivery devices, and systems. In this vein, a broad overview of the current status of superficial, interstitial, and deep PDT modalities-and a critical review of light sources and their effects on the PDT process-are presented. Insight into the technical advancements and remaining challenges of optical sources and light devices is provided from a physical and bioengineering perspective.
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Affiliation(s)
- José Francisco Algorri
- Photonics Engineering Group, University of Cantabria, 39005 Santander, Spain; (M.O.); (P.R.-V.); (J.M.L.-H.)
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Mario Ochoa
- Photonics Engineering Group, University of Cantabria, 39005 Santander, Spain; (M.O.); (P.R.-V.); (J.M.L.-H.)
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Pablo Roldán-Varona
- Photonics Engineering Group, University of Cantabria, 39005 Santander, Spain; (M.O.); (P.R.-V.); (J.M.L.-H.)
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
- CIBER-bbn, Institute of Health Carlos III, 28029 Madrid, Spain;
| | | | - José Miguel López-Higuera
- Photonics Engineering Group, University of Cantabria, 39005 Santander, Spain; (M.O.); (P.R.-V.); (J.M.L.-H.)
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
- CIBER-bbn, Institute of Health Carlos III, 28029 Madrid, Spain;
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18
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Komolibus K, Fisher C, Swartling J, Svanberg S, Svanberg K, Andersson-Engels S. Perspectives on interstitial photodynamic therapy for malignant tumors. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210111-PERR. [PMID: 34302323 PMCID: PMC8299827 DOI: 10.1117/1.jbo.26.7.070604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/08/2021] [Indexed: 05/17/2023]
Abstract
SIGNIFICANCE Despite remarkable advances in the core modalities used in combating cancer, malignant diseases remain the second largest cause of death globally. Interstitial photodynamic therapy (IPDT) has emerged as an alternative approach for the treatment of solid tumors. AIM The aim of our study is to outline the advancements in IPDT in recent years and provide our vision for the inclusion of IPDT in standard-of-care (SoC) treatment guidelines of specific malignant diseases. APPROACH First, the SoC treatment for solid tumors is described, and the attractive properties of IPDT are presented. Second, the application of IPDT for selected types of tumors is discussed. Finally, future opportunities are considered. RESULTS Strong research efforts in academic, clinical, and industrial settings have led to significant improvements in the current implementation of IPDT, and these studies have demonstrated the unique advantages of this modality for the treatment of solid tumors. It is envisioned that further randomized prospective clinical trials and treatment optimization will enable a wide acceptance of IPDT in the clinical community and inclusion in SoC guidelines for well-defined clinical indications. CONCLUSIONS The minimally invasive nature of this treatment modality combined with the relatively mild side effects makes IPDT a compelling alternative option for treatment in a number of clinical applications. The adaptability of this technique provides many opportunities to both optimize and personalize the treatment.
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Affiliation(s)
- Katarzyna Komolibus
- Tyndall National Institute, Biophotonics@Tyndall, IPIC, Cork, Ireland
- Address all correspondence to Katarzyna Komolibus,
| | - Carl Fisher
- Tyndall National Institute, Biophotonics@Tyndall, IPIC, Cork, Ireland
| | | | - Sune Svanberg
- Lund University, Department of Physics, Lund, Sweden
- South China Normal University, South China Academy of Advanced Optoelectronics, Guangzhou, China
| | - Katarina Svanberg
- South China Normal University, South China Academy of Advanced Optoelectronics, Guangzhou, China
- Lund University Hospital, Department of Clinical Sciences, Lund, Sweden
| | - Stefan Andersson-Engels
- Tyndall National Institute, Biophotonics@Tyndall, IPIC, Cork, Ireland
- University College Cork, Department of Physics, Cork, Ireland
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19
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Hamblin MR, Abrahamse H. Factors Affecting Photodynamic Therapy and Anti-Tumor Immune Response. Anticancer Agents Med Chem 2021; 21:123-136. [PMID: 32188394 DOI: 10.2174/1871520620666200318101037] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/15/2020] [Accepted: 01/29/2020] [Indexed: 11/22/2022]
Abstract
Photodynamic Therapy (PDT) is a cancer therapy involving the systemic injection of a Photosensitizer (PS) that localizes to some extent in a tumor. After an appropriate time (ranging from minutes to days), the tumor is irradiated with red or near-infrared light either as a surface spot or by interstitial optical fibers. The PS is excited by the light to form a long-lived triplet state that can react with ambient oxygen to produce Reactive Oxygen Species (ROS) such as singlet oxygen and/or hydroxyl radicals, that kill tumor cells, destroy tumor blood vessels, and lead to tumor regression and necrosis. It has long been realized that in some cases, PDT can also stimulate the host immune system, leading to a systemic anti-tumor immune response that can also destroy distant metastases and guard against tumor recurrence. The present paper aims to cover some of the factors that can affect the likelihood and efficiency of this immune response. The structure of the PS, drug-light interval, rate of light delivery, mode of cancer cell death, expression of tumor-associated antigens, and combinations of PDT with various adjuvants all can play a role in stimulating the host immune system. Considering the recent revolution in tumor immunotherapy triggered by the success of checkpoint inhibitors, it appears that the time is ripe for PDT to be investigated in combination with other approaches in clinical scenarios.
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Affiliation(s)
- Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa
| | - Heidi Abrahamse
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa
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20
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Ostańska E, Aebisher D, Bartusik-Aebisher D. The potential of photodynamic therapy in current breast cancer treatment methodologies. Biomed Pharmacother 2021; 137:111302. [PMID: 33517188 DOI: 10.1016/j.biopha.2021.111302] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 02/08/2023] Open
Abstract
Photodynamic Therapy (PDT) has been known for over a hundred years, and currently gaining in acceptance as an alternative cancer treatment. Light delivery is still a difficult problem in deep cancer treatment with PDT. Only near-infrared light in the 700-1100 nm range can penetrate deeply into the tissue because most tissue chromophores, including oxyhemoglobin, deoxyhemoglobin, melanin and fat, poorly absorb in the near infrared window. The light sources used in PDT are lasers, arc lamps, light-emitting diodes and fluorescent lamps. PDT has been used for many different clinical applications. PDT may be excellent alternative in the treatment and diagnosis of breast cancer compared to the conventional surgery, chemotherapy and radiotherapy. The basic elements of PDT are an appropriate photosensitizer (PS), oxygen, and light. The effectiveness of photodynamic therapy depends on the induction of photocytotoxic reactions, which are the result of light activation of PS), pre-administered to the body. The condition for initiating PDT processes is light absorption by PS and subsequent localized generation of cytotoxic reactive oxygen species. This study is a review of empirical research aimed at improving the therapy and diagnosis of breast cancer using PDT based on the physicochemical differences in healthy and diseased tissues and the tissues undergoing treatment.
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Affiliation(s)
| | - David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of The University of Rzeszów, Rzeszów, Poland
| | - Dorota Bartusik-Aebisher
- Department of Biochemistry and General Chemistry, Medical College of The University of Rzeszów, Rzeszów, Poland.
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21
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Kirino I, Fujita K, Sakanoue K, Sugita R, Yamagishi K, Takeoka S, Fujie T, Uemoto S, Morimoto Y. Metronomic photodynamic therapy using an implantable LED device and orally administered 5-aminolevulinic acid. Sci Rep 2020; 10:22017. [PMID: 33328544 PMCID: PMC7744509 DOI: 10.1038/s41598-020-79067-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/02/2020] [Indexed: 11/23/2022] Open
Abstract
Metronomic photodynamic therapy (mPDT) is a form of PDT that induces cancer cell death by intermittent continuous irradiation with a relatively weak power of light for a long duration (several days). We previously developed a wirelessly powered, fully implantable LED device and reported a significant anti-tumor effect of mPDT. Considering application in clinical practice, the method used for repeated administrations of photosensitizers required for mPDT should not have a high patient burden such as the burden of transvenous administration. Therefore, in this study, we selected 5-aminolevulinic acid (ALA), which can be administered orally, as a photosensitizer, and we studied the antitumor effects of mPDT. In mice with intradermal tumors that were orally administered ALA (200 mg/kg daily for 5 days), the tumor in each mouse was simultaneously irradiated (8 h/day for 5 days) using a wirelessly powered implantable green LED device (532 nm, 0.05 mW). Tumor growth in the mPDT-treated mice was suppressed by about half compared to that in untreated mice. The results showed that mPDT using the wirelessly powered implantable LED device exerted an antitumor effect even with the use of orally administered ALA, and this treatment scheme can reduce the burden of photosensitizer administration for a patient.
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Affiliation(s)
- Izumi Kirino
- Department of Physiology, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama, 359-8513, Japan
- Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Katsuhiko Fujita
- Institute for Materials Chemistry and Engineering, Kyushu University, Fukuoka, Japan
| | | | - Rin Sugita
- Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Kento Yamagishi
- Research Organization for Nano & Life Innovation, Waseda University, Tokyo, Japan
| | - Shinji Takeoka
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan
| | - Toshinori Fujie
- Research Organization for Nano & Life Innovation, Waseda University, Tokyo, Japan
- School of Life Science and Technology, Tokyo Institute of Technology, Tokyo, Japan
| | - Shinji Uemoto
- Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuji Morimoto
- Department of Physiology, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama, 359-8513, Japan.
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22
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Kim HI, Wilson BC. Photodynamic Diagnosis and Therapy for Peritoneal Carcinomatosis from Gastrointestinal Cancers: Status, Opportunities, and Challenges. J Gastric Cancer 2020; 20:355-375. [PMID: 33425438 PMCID: PMC7781745 DOI: 10.5230/jgc.2020.20.e39] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 12/15/2020] [Indexed: 12/21/2022] Open
Abstract
Selective accumulation of a photosensitizer and the subsequent response in only the light-irradiated target are advantages of photodynamic diagnosis and therapy. The limited depth of the therapeutic effect is a positive characteristic when treating surface malignancies, such as peritoneal carcinomatosis. For photodynamic diagnosis (PDD), adjunctive use of aminolevulinic acid- protoporphyrin IX-guided fluorescence imaging detects cancer nodules, which would have been missed during assessment using white light visualization only. Furthermore, since few side effects have been reported, this has the potential to become a vital component of diagnostic laparoscopy. A variety of photosensitizers have been examined for photodynamic therapy (PDT), and treatment protocols are heterogeneous in terms of photosensitizer type and dose, photosensitizer-light time interval, and light source wavelength, dose, and dose rate. Although several studies have suggested that PDT has favorable effects in peritoneal carcinomatosis, clinical trials in more homogenous patient groups are required to identify the true benefits. In addition, major complications, such as bowel perforation and capillary leak syndrome, need to be reduced. In the long term, PDD and PDT are likely to be successful therapeutic options for patients with peritoneal carcinomatosis, with several options to optimize the photosensitizer and light delivery parameters to improve safety and efficacy.
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Affiliation(s)
- Hyoung-Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Gastric Cancer Center, Yonsei Cancer Center, Seoul, Korea
- Open NBI Convergence Technology Research Laboratory, Severance Hospital, Seoul, Korea
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Brian C. Wilson
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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23
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Wang Y, Wang H, Zhou L, Lu J, Jiang B, Liu C, Guo J. Photodynamic therapy of pancreatic cancer: Where have we come from and where are we going? Photodiagnosis Photodyn Ther 2020; 31:101876. [PMID: 32534246 DOI: 10.1016/j.pdpdt.2020.101876] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022]
Abstract
Photodynamic therapy (PDT) is a potential adjuvant therapy in pancreatic cancer with several advantages. Mechanistically, pancreatic cancer PDT can induce apoptosis and necrosis of pancreatic cancer cells and lead to vascular damage and enhance anti-tumor immune response in tumor tissues. However, limitations of current photosensitizers such as limited penetration depth, poor targeted therapy and inadequate reactive oxygen species (ROS) generation still exist. Recently, several novel photosensitizers have been reported to break through limits in pancreatic cancer PDT. Methods combined with biomedical engineering, materialogy and chemical engineering have been employed to overcome the difficulties and to realize targeted therapy. Preclinical and clinical trials also preliminarily confirmed the technical feasibility and safety of pancreatic cancer PDT. Therefore, PDT may be potential to be used as an effective adjuvant therapy in pancreatic cancer multimodality therapy. This review will give an overview about pancreatic cancer PDT from basic experimental studies, preclinical and clinical application to future direction of pancreatic cancer PDT.
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Affiliation(s)
- Yizhi Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hongwei Wang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Li Zhou
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jun Lu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Bolun Jiang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Chengxi Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Junchao Guo
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
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24
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Falk-Mahapatra R, Gollnick SO. Photodynamic Therapy and Immunity: An Update. Photochem Photobiol 2020; 96:550-559. [PMID: 32128821 DOI: 10.1111/php.13253] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/04/2020] [Indexed: 12/18/2022]
Abstract
Dr. Thomas Dougherty and his Oncology Foundation of Buffalo were the first to support my (S.O.G.) research into the effects of photodynamic therapy (PDT) on the host immune system. The small grant I was awarded in 2002 launched my career as an independent researcher; at the time, there were few studies on the importance of the immune response on the efficacy of PDT and no studies demonstrating the ability of PDT to enhance antitumor immunity. Over the last decades, the interest in PDT as an enhancer of antitumor immunity and our understanding of the mechanisms by which PDT enhances antitumor immunity have dramatically increased. In this review article, we look back on the studies that laid the foundation for our understanding and provide an update on current advances and therapies that take advantage of PDT enhancement of immunity.
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Affiliation(s)
| | - Sandra O Gollnick
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY.,Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, NY
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Photodynamic Therapy in Primary Breast Cancer. J Clin Med 2020; 9:jcm9020483. [PMID: 32050675 PMCID: PMC7074474 DOI: 10.3390/jcm9020483] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 01/28/2020] [Accepted: 02/04/2020] [Indexed: 01/05/2023] Open
Abstract
Photodynamic therapy (PDT) is a technique for producing localized necrosis with light after prior administration of a photosensitizing agent. This study investigates the nature, safety, and efficacy of PDT for image-guided treatment of primary breast cancer. We performed a phase I/IIa dose escalation study in 12 female patients with a new diagnosis of invasive ductal breast cancer and scheduled to undergo mastectomy as a first treatment. The photosensitizer verteporfin (0.4 mg/kg) was administered intravenously followed by exposure to escalating light doses (20, 30, 40, 50 J; 3 patients per dose) delivered via a laser fiber positioned interstitially under ultrasound guidance. MRI (magnetic resonance imaging) scans were performed prior to and 4 days after PDT. Histological examination of the excised tissue was performed. PDT was well tolerated, with no adverse events. PDT effects were detected by MRI in 7 patients and histology in 8 patients, increasing in extent with the delivered light dose, with good correlation between the 2 modalities. Histologically, there were distinctive features of PDT necrosis, in contrast to spontaneous necrosis. Apoptosis was detected in adjacent normal tissue. Median follow-up of 50 months revealed no adverse effects and outcomes no worse than a comparable control population. This study confirms a potential role for PDT in the management of early breast cancer.
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Yanovsky RL, Bartenstein DW, Rogers GS, Isakoff SJ, Chen ST. Photodynamic therapy for solid tumors: A review of the literature. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:295-303. [DOI: 10.1111/phpp.12489] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 04/26/2019] [Accepted: 05/26/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Diana W. Bartenstein
- Harvard Medical School Boston Massachusetts USA
- Internal Medicine Residency Program Brigham & Women's Hospital Boston Massachusetts USA
| | - Gary S. Rogers
- Tufts University School of Medicine Boston Massachusetts USA
| | - Steven J. Isakoff
- Department of Hematology Oncology Massachusetts General Hospital Boston Massachusetts USA
- Department of Dermatology Massachusetts General Hospital Boston Massachusetts USA
| | - Steven T. Chen
- Harvard Medical School Boston Massachusetts USA
- Department of Dermatology Massachusetts General Hospital Boston Massachusetts USA
- Division of General Internal Medicine, Department of Internal Medicine Massachusetts General Hospital Boston Massachusetts USA
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Wadasadawala T, Vadgaonkar R, Bajpai J. Management of Isolated Locoregional Recurrences in Breast Cancer: A Review of Local and Systemic Modalities. Clin Breast Cancer 2017; 17:493-502. [DOI: 10.1016/j.clbc.2017.03.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/21/2017] [Accepted: 03/13/2017] [Indexed: 11/25/2022]
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Lee J, Park HY, Kim WW, Jeong JY, Lee YD, Choi MH, Kim S, Park JY, Jung JH. Combination Treatment with Photodynamic Therapy and Laser Ablation in Breast Cancer: An Animal Model Study. Photomed Laser Surg 2017; 35:505-512. [DOI: 10.1089/pho.2017.4291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Jeeyeon Lee
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Ho Yong Park
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Wan Wook Kim
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Ji Yun Jeong
- Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Yong-Deok Lee
- Center for Theragnosis, Korea Institute of Science and Technology, Republic of Korea
| | - Mi-Hwa Choi
- Center for Theragnosis, Korea Institute of Science and Technology, Republic of Korea
| | - Sehoon Kim
- Center for Theragnosis, Korea Institute of Science and Technology, Republic of Korea
| | - Ji-Young Park
- Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Jin Hyang Jung
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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Theodossiou TA, Olsen CE, Jonsson M, Kubin A, Hothersall JS, Berg K. The diverse roles of glutathione-associated cell resistance against hypericin photodynamic therapy. Redox Biol 2017; 12:191-197. [PMID: 28254657 PMCID: PMC5333531 DOI: 10.1016/j.redox.2017.02.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 02/21/2017] [Accepted: 02/23/2017] [Indexed: 12/27/2022] Open
Abstract
The diverse responses of different cancers to treatments such as photodynamic therapy of cancer (PDT) have fueled a growing need for reliable predictive markers for treatment outcome. In the present work we have studied the differential response of two phenotypically and genotypically different breast adenocarcinoma cell lines, MCF7 and MDA-MB-231, to hypericin PDT (HYP-PDT). MDA-MB-231 cells were 70% more sensitive to HYP PDT than MCF7 cells at LD50. MCF7 were found to express a substantially higher level of glutathione peroxidase (GPX4) than MDA-MB-231, while MDA-MB-231 differentially expressed glutathione-S-transferase (GSTP1), mainly used for xenobiotic detoxification. Eighty % reduction of intracellular glutathione (GSH) by buthionine sulfoximine (BSO), largely enhanced the sensitivity of the GSTP1 expressing MDA-MB-231 cells to HYP-PDT, but not in MCF7 cells. Further inhibition of the GSH reduction however by carmustine (BCNU) resulted in an enhanced sensitivity of MCF7 to HYP-PDT. HYP loading studies suggested that HYP can be a substrate of GSTP for GSH conjugation as BSO enhanced the cellular HYP accumulation by 20% in MDA-MB-231 cells, but not in MCF7 cells. Studies in solutions showed that L-cysteine can bind the GSTP substrate CDNB in the absence of GSTP. This means that the GSTP-lacking MCF7 may use L-cysteine for xenobiotic detoxification, especially during GSH synthesis inhibition, which leads to L-cysteine build-up. This was confirmed by the lowered accumulation of HYP in both cell lines in the presence of BSO and the L-cysteine source NAC. NAC reduced the sensitivity of MCF7, but not MDA-MB-231, cells to HYP PDT which is in accordance with the antioxidant effects of L-cysteine and its potential as a GSTP substrate. As a conclusion we have herein shown that the different GSH based cell defense mechanisms can be utilized as predictive markers for the outcome of PDT and as a guide for selecting optimal combination strategies.
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Affiliation(s)
- Theodossis A Theodossiou
- Department of Radiation Biology, Institute for cancer Research, Radium Hospital, Oslo University Hospital, Montebello, 0379 Oslo, Norway.
| | - Cathrine E Olsen
- Department of Radiation Biology, Institute for cancer Research, Radium Hospital, Oslo University Hospital, Montebello, 0379 Oslo, Norway
| | - Marte Jonsson
- Department of Radiation Biology, Institute for cancer Research, Radium Hospital, Oslo University Hospital, Montebello, 0379 Oslo, Norway
| | - Andreas Kubin
- PLANTA Naturstoffe Vertriebs GmbH, A-1120 Wien, Austria
| | - John S Hothersall
- Department of Radiation Biology, Institute for cancer Research, Radium Hospital, Oslo University Hospital, Montebello, 0379 Oslo, Norway
| | - Kristian Berg
- Department of Radiation Biology, Institute for cancer Research, Radium Hospital, Oslo University Hospital, Montebello, 0379 Oslo, Norway
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Tong L, Zhang K, Huang H, Zhang W, Zhang X, Wang Q, Li Q, Bai C. Comparison of the efficacy of four endobronchial ablation techniques in dogs. Exp Ther Med 2017; 13:169-177. [PMID: 28123486 PMCID: PMC5245072 DOI: 10.3892/etm.2016.3946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/23/2016] [Indexed: 12/27/2022] Open
Abstract
The present study aimed to evaluate the safety and efficacy of four commonly used ablation techniques, namely neodymium-doped yttrium aluminium garnet (Nd:YAG) laser therapy, argon plasma coagulation (APC), high-frequency electrocautery and CO2 cryotherapy. The techniques were performed at various powers or impedance settings, and for various durations, on the trachea of beagle dogs. Pathological changes of the tracheal wall were assessed by bronchoscopy. The endoscopic gross appearance of lesions induced by ablation treatments was consistent with the histopathological changes. The results suggested that cryotherapy was relatively safe, whereas APC induced superficial tissue coagulative necrosis. Furthermore, Nd:YAG laser therapy was the most efficient technique and showed the greatest penetration potential. In general, tissue injury was exacerbated with extended application time, at constant power or impedance. The safest application parameters were 20 W for ≤1 sec for Nd:YAG laser therapy, 40 W for ≤3 sec for electrocautery, 40 W for ≤5 sec for APC and 100 Ω for ≤120 sec for cryotherapy. At the maximum times, these settings resulted in identical pathological changes. Healing of the lesions following ablation was achieved within 3 weeks. The Nd:YAG laser, APC, electrocautery and cryotherapy endobronchial ablation techniques differed according to their potential and limitations for application on the trachea. However, when applied at specific combinations of power or impedance and duration, they exhibited similar efficacies.
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Affiliation(s)
- Linrong Tong
- Department of Respiratory Medicine, Xiamen 174 Hospital, Xiamen, Fujian 361000, P.R. China
- Department of Respiratory Medicine, Changhai Hospital, Shanghai 200433, P.R. China
| | - Koudong Zhang
- Department of Respiratory Medicine, Yancheng City First People's Hospital, Yancheng, Jiangsu 224000, P.R. China
| | - Haidong Huang
- Department of Respiratory Medicine, Changhai Hospital, Shanghai 200433, P.R. China
| | - Wei Zhang
- Department of Respiratory Medicine, Changhai Hospital, Shanghai 200433, P.R. China
| | - Xingxing Zhang
- Department of Respiratory Medicine, Changhai Hospital, Shanghai 200433, P.R. China
| | - Qin Wang
- Department of Respiratory Medicine, Changhai Hospital, Shanghai 200433, P.R. China
| | - Qiang Li
- Department of Respiratory Medicine, Changhai Hospital, Shanghai 200433, P.R. China
| | - Chong Bai
- Department of Respiratory Medicine, Changhai Hospital, Shanghai 200433, P.R. China
- Correspondence to: Dr Chong Bai, Department of Respiratory Medicine, Changhai Hospital, 168 Changhai Road, Shanghai 200433, P.R. China, E-mail:
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Boosting Tumor-Specific Immunity Using PDT. Cancers (Basel) 2016; 8:cancers8100091. [PMID: 27782066 PMCID: PMC5082381 DOI: 10.3390/cancers8100091] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 10/04/2016] [Indexed: 01/06/2023] Open
Abstract
Photodynamic therapy (PDT) is a cancer treatment with a long-standing history. It employs the application of nontoxic components, namely a light-sensitive photosensitizer and visible light, to generate reactive oxygen species (ROS). These ROS lead to tumor cell destruction, which is accompanied by the induction of an acute inflammatory response. This inflammatory process sends a danger signal to the innate immune system, which results in activation of specific cell types and release of additional inflammatory mediators. Activation of the innate immune response is necessary for subsequent induction of the adaptive arm of the immune system. This includes the priming of tumor-specific cytotoxic T lymphocytes (CTL) that have the capability to directly recognize and kill cells which display an altered self. The past decades have brought increasing appreciation for the importance of the generation of an adaptive immune response for long-term tumor control and induction of immune memory to combat recurrent disease. This has led to considerable effort to elucidate the immune effects PDT treatment elicits. In this review we deal with the progress which has been made during the past 20 years in uncovering the role of PDT in the induction of the tumor-specific immune response, with special emphasis on adaptive immunity.
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Arun R, Dhivya S, Abraham SK, Premkumar K. Low-dose chemotherapeutic drugs induce reactive oxygen species and initiate apoptosis-mediated genomic instability. Toxicol Res (Camb) 2016; 5:547-556. [PMID: 30090369 PMCID: PMC6062221 DOI: 10.1039/c5tx00391a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/05/2016] [Indexed: 11/21/2022] Open
Abstract
Prolonged cancer cell survival, acquiring drug resistance, and secondary cancer development despite chemotherapy are the major challenges during cancer treatment, whose underlying mechanism still remains elusive. In this study, low-doses of chemotherapeutic drugs (LDCD) - doxorubicin (DOX), etoposide (ETOP), and busulfan (BUS) were used to ascertain the effect of residual concentrations of drugs on breast cancer cells. Our results showed that exposure to LDCD caused significant induction of ROS, early signs of apoptosis and accumulation of cells in S and G2-M phases of the cell cycle in MCF-7 and MDA-MB-231 cell lines. Under drug-free recovery conditions, a decrease in the number of apoptotic cells and an increase in the number of colonies formed were observed. Analysis of the molecular mechanism showed lower expression of cleaved products of caspase 3, 9, PARP and occurrence of DNA strand breaks in recovered cells compared to LDCD-treated cells, suggesting incomplete cell death activation and survival of cells with genomic damage after therapeutic insult. Thus, LDCD induces defective apoptosis in cancer cells allowing a small population of cells to escape from cell cycle check points and survive with accumulated genetic damage that could eventually result in secondary cancers that warrants further studies for better therapeutic strategies.
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Affiliation(s)
- Renganathan Arun
- Cancer Genetics and Nanomedicine Laboratory , Department of Biomedical Science , School of Basic Medical Sciences , Bharathidasan University , Tiruchirappalli 620024 , Tamilnadu , India . ; ; Tel: +91-8056589893
| | - Sridaran Dhivya
- Cancer Genetics and Nanomedicine Laboratory , Department of Biomedical Science , School of Basic Medical Sciences , Bharathidasan University , Tiruchirappalli 620024 , Tamilnadu , India . ; ; Tel: +91-8056589893
| | - Suresh K Abraham
- School of Life Sciences , Jawaharlal Nehru University , New Delhi 110067 , India
| | - Kumpati Premkumar
- Cancer Genetics and Nanomedicine Laboratory , Department of Biomedical Science , School of Basic Medical Sciences , Bharathidasan University , Tiruchirappalli 620024 , Tamilnadu , India . ; ; Tel: +91-8056589893
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33
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Ahn PH, Quon H, O'Malley BW, Weinstein G, Chalian A, Malloy K, Atkins JH, Sollecito T, Greenberg M, McNulty S, Lin A, Zhu TC, Finlay JC, Cengel K, Livolsi V, Feldman M, Mick R, Busch TM. Toxicities and early outcomes in a phase 1 trial of photodynamic therapy for premalignant and early stage head and neck tumors. Oral Oncol 2016; 55:37-42. [PMID: 26865261 DOI: 10.1016/j.oraloncology.2016.01.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/17/2016] [Accepted: 01/20/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Management of early superficial lesions in the head and neck remains complex. We performed a phase 1 trial for high-grade premalignant and early superficial lesions of the head and neck using photodynamic therapy (PDT) with Levulan (ALA). MATERIALS AND METHODS Thirty-five subjects with high grade dysplasia, carcinoma in situ, or microinvasive (⩽1.5mm depth) squamous cell carcinoma were enrolled. Cohorts of 3-6 patients were given escalating intraoperative light doses of 50-200J/cm(2) 4-6h after oral administration of 60mg/kg ALA. Light at 629-635nm was delivered in a continuous (unfractionated) or fractionated (two-part) schema. RESULTS PDT was delivered to 30/35 subjects, with 29 evaluable. There was one death possibly due to the treatment. The regimen was otherwise tolerable, with a 52% rate of grade 3 mucositis which healed within several weeks. Other toxicities were generally grade 1 or 2, including odynophagia (one grade 4), voice alteration (one grade 3), and photosensitivity reactions. One patient developed grade 5 sepsis. With a median follow-up of 42months, 10 patients (34%) developed local recurrence; 4 of these received 50J/cm(2) and two each received 100, 150, and 200J/cm(2). Ten (34%) patients developed recurrence adjacent to the treated field. There was a 69% complete response rate at 3months. CONCLUSIONS ALA-PDT is well tolerated. Maximum Tolerated Dose appears to be higher than the highest dose used in this study. Longer followup is required to analyze effect of light dose on local recurrence. High marginal recurrence rates suggest use of larger treatment fields.
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Affiliation(s)
- Peter H Ahn
- Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States.
| | - Harry Quon
- Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States; Department of Radiation Oncology, Johns Hopkins University, 401 N. Broadway, Baltimore, MA 21231, United States
| | - Bert W O'Malley
- Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States
| | - Gregory Weinstein
- Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States
| | - Ara Chalian
- Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States
| | - Kelly Malloy
- Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States; Department of Otolaryngology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI 48109, United States
| | - Joshua H Atkins
- Department of Anesthesiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States
| | - Thomas Sollecito
- Department of Oral Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| | - Martin Greenberg
- Department of Oral Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| | - Sally McNulty
- Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| | - Alexander Lin
- Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| | - Timothy C Zhu
- Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| | - Jarod C Finlay
- Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| | - Keith Cengel
- Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| | - Virginia Livolsi
- Department of Pathology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States
| | - Michael Feldman
- Department of Pathology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States
| | - Rosemarie Mick
- Department of Biostatistics and Epidemiology, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, United States
| | - Theresa M Busch
- Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
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Zhang D, Liu H, Wei Q, Zhou Q. Structure-activity relationship study of anticancer thymidine-quinoxaline conjugates under the low radiance of long wavelength ultraviolet light for photodynamic therapy. Eur J Med Chem 2015; 107:180-91. [PMID: 26584085 DOI: 10.1016/j.ejmech.2015.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 11/04/2015] [Accepted: 11/04/2015] [Indexed: 02/07/2023]
Abstract
Thymidine quinoxaline conjugate (dT-QX) is a thymidine analog with selective cytotoxicity against different cancer cells. In this study, the structure activity relationship study of dT-QX analogs was carried out under the low radiance of black fluorescent (UVA-1) light. Significantly enhanced cytotoxicity was observed under UVA-1 activation among analogs containing both thymidine and quinoxaline moieties with different length of the linker, stereochemical configuration and halogenated substituents. Among these analogs, the thymidine dichloroquinoxaline conjugate exhibited potent activity under UVA-1 activation as the best candidate with EC50 at 0.67 μM and 1.3 μM against liver and pancreatic cancer cells, respectively. In contrast, the replacement of thymidine moiety with a galactosyl residue or the replacement of quinoxaline moiety with a fluorescent pyrenyl residue or a simplified diketone structure resulted in the full loss of activity. Furthermore, it was revealed that the low radiance of UVA-1 at 3 mW/cm(2) for 20 min was sufficient enough to induce the full cytotoxicity of thymidine dichloroquinoxaline conjugate and that the cytotoxic mechanism was achieved through a rapid and steady production of reactive oxygen species.
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Affiliation(s)
- Dejun Zhang
- Department of Nanomedicine and Biopharmaceuticals, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huaming Liu
- Department of Nanomedicine and Biopharmaceuticals, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiong Wei
- Department of Nanomedicine and Biopharmaceuticals, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qibing Zhou
- Department of Nanomedicine and Biopharmaceuticals, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Aggarwal N, Santiago AM, Kessel D, Sloane BF. Photodynamic therapy as an effective therapeutic approach in MAME models of inflammatory breast cancer. Breast Cancer Res Treat 2015; 154:251-62. [PMID: 26502410 DOI: 10.1007/s10549-015-3618-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/20/2015] [Indexed: 12/18/2022]
Abstract
Photodynamic therapy (PDT) is a minimally invasive, FDA-approved therapy for treatment of endobronchial and esophageal cancers that are accessible to light. Inflammatory breast cancer (IBC) is an aggressive and highly metastatic form of breast cancer that spreads to dermal lymphatics, a site that would be accessible to light. IBC patients have a relatively poor survival rate due to lack of targeted therapies. The use of PDT is underexplored for breast cancers but has been proposed for treatment of subtypes for which a targeted therapy is unavailable. We optimized and used a 3D mammary architecture and microenvironment engineering (MAME) model of IBC to examine the effects of PDT using two treatment protocols. The first protocol used benzoporphyrin derivative monoacid A (BPD) activated at doses ranging from 45 to 540 mJ/cm(2). The second PDT protocol used two photosensitizers: mono-L-aspartyl chlorin e6 (NPe6) and BPD that were sequentially activated. Photokilling by PDT was assessed by live-dead assays. Using a MAME model of IBC, we have shown a significant dose-response in photokilling by BPD-PDT. Sequential activation of NPe6 followed by BPD is more effective in photokilling of tumor cells than BPD alone. Sequential activation at light doses of 45 mJ/cm(2) for each agent resulted in >90 % cell death, a response only achieved by BPD-PDT at a dose of 360 mJ/cm(2). Our data also show that effects of PDT on a volumetric measurement of 3D MAME structures reflect efficacy of PDT treatment. Our study is the first to demonstrate the potential of PDT for treating IBC.
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Affiliation(s)
- Neha Aggarwal
- Department of Physiology, Wayne State University School of Medicine, 540 East Canfield, Detroit, MI, 48201, USA.
| | - Ann Marie Santiago
- Department of Pharmacology, Wayne State University School of Medicine, 540 East Canfield, Detroit, MI, 48201, USA.
| | - David Kessel
- Department of Pharmacology, Wayne State University School of Medicine, 540 East Canfield, Detroit, MI, 48201, USA.
| | - Bonnie F Sloane
- Department of Pharmacology, Wayne State University School of Medicine, 540 East Canfield, Detroit, MI, 48201, USA.
- Department of Oncology, Wayne State University School of Medicine, 540 East Canfield, Detroit, MI, 48201, USA.
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Marchal S, Dolivet G, Lassalle HP, Guillemin F, Bezdetnaya L. Targeted photodynamic therapy in head and neck squamous cell carcinoma: heading into the future. Lasers Med Sci 2015; 30:2381-7. [PMID: 25563461 DOI: 10.1007/s10103-014-1703-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 12/18/2014] [Indexed: 12/16/2022]
Abstract
The aim of this article is to give an insight into the future of photodynamic therapy (PDT) in head and neck squamous cell carcinoma (HNSCC). Through the combination of a photosensitizing agent with light and oxygen, PDT produces highly cytotoxic reactive oxygen species leading to selective tumor eradication. PDT is an attractive treatment for focal therapy of localized tumors, especially in the case of unresectable tumors. In HNSCC, over 1500 patients have been treated by PDT, and the majority of them responded quite favorably to this treatment. However, the non-negligible photosensitization of healthy tissue is a major limitation for the clinical application of PDT. Improvement in tumor selectivity is the main challenge that can be taken up by the use of a new generation of photosensitizing nanoparticles. Passive targeting, by using functionalised nanocarriers to target to overexpressed transmembrane receptors afford attractive solutions. To this day, epidermal growth factor receptor (EGFR) remains the only validated molecular target for HNSCC, and photosensitizer immunoconjugates to EGFR have been developed for the intracellular delivery of photosensitizing agents. Depending on coordinated research between biomarkers, specific ligands, and photosensitizers, similar approaches could be rapidly developed. In addition, some photosensitizers hold high fluorescence yield and therefore could emerge as theranostic agents.
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Affiliation(s)
- Sophie Marchal
- Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, Université de Lorraine, 54506, Vandoeuvre-lès-Nancy Cedex, France. .,CNRS, Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, 54506, Vandoeuvre-lès-Nancy Cedex, France. .,Research Unit, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54519, Vandoeuvre-lès-Nancy Cedex, France.
| | - Gilles Dolivet
- Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, Université de Lorraine, 54506, Vandoeuvre-lès-Nancy Cedex, France.,CNRS, Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, 54506, Vandoeuvre-lès-Nancy Cedex, France.,Surgery Department, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54519, Vandoeuvre-lès-Nancy Cedex, France
| | - Henri-Pierre Lassalle
- Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, Université de Lorraine, 54506, Vandoeuvre-lès-Nancy Cedex, France.,CNRS, Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, 54506, Vandoeuvre-lès-Nancy Cedex, France.,Research Unit, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54519, Vandoeuvre-lès-Nancy Cedex, France
| | - François Guillemin
- Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, Université de Lorraine, 54506, Vandoeuvre-lès-Nancy Cedex, France.,CNRS, Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, 54506, Vandoeuvre-lès-Nancy Cedex, France.,Surgery Department, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54519, Vandoeuvre-lès-Nancy Cedex, France
| | - Lina Bezdetnaya
- Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, Université de Lorraine, 54506, Vandoeuvre-lès-Nancy Cedex, France.,CNRS, Centre de Recherche en Automatique de Nancy (CRAN), UMR 7039, Campus Sciences, 54506, Vandoeuvre-lès-Nancy Cedex, France.,Research Unit, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54519, Vandoeuvre-lès-Nancy Cedex, France
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