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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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Folate-based radiotracers for nuclear imaging and radionuclide therapy. Coord Chem Rev 2022. [DOI: 10.1016/j.ccr.2022.214702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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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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Xu S, Bulin AL, Hurbin A, Elleaume H, Coll JL, Broekgaarden M. Photodynamic Diagnosis and Therapy for Peritoneal Carcinomatosis: Emerging Perspectives. Cancers (Basel) 2020; 12:cancers12092491. [PMID: 32899137 PMCID: PMC7563129 DOI: 10.3390/cancers12092491] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/24/2020] [Accepted: 09/01/2020] [Indexed: 12/22/2022] Open
Abstract
Simple Summary Peritoneal carcinomatosis, the formation of wide-spread metastases throughout the abdominal cavity, remains challenging to diagnose and treat. Photodynamic diagnosis and photodynamic therapy are promising approaches for the diagnosis and treatment of peritoneal carcinomatosis, which use photosensitizers for fluorescence detection or photochemical treatment of (micro) metastases. With the aim of highlighting the potential of this theranostic approach, this review outlines the clinical state of the art in the use of photodynamic diagnosis and therapy for peritoneal carcinomatosis, identifies the major challenges, and provides emerging perspectives from preclinical studies to address these challenges. We conclude that the development of novel illumination strategies and targeted photonanomedicines may aid in achieving more efficient cytoreductive surgery. In addition to combination treatments with chemo-, and radiotherapy, such approaches hold significant promise to improve the outlook of patients with peritoneal carcinomatosis. Abstract Peritoneal carcinomatosis occurs frequently in patients with advanced stage gastrointestinal and gynecological cancers. The wide-spread peritoneal micrometastases indicate a poor outlook, as the tumors are difficult to diagnose and challenging to completely eradicate with cytoreductive surgery and chemotherapeutics. Photodynamic diagnosis (PDD) and therapy (PDT), modalities that use photosensitizers for fluorescence detection or photochemical treatment of cancer, are promising theranostic approaches for peritoneal carcinomatosis. This review discusses the leading clinical trials, identifies the major challenges, and presents potential solutions to advance the use of PDD and PDT for the treatment of peritoneal carcinomatosis. While PDD for fluorescence-guided surgery is practically feasible and has achieved clinical success, large randomized trials are required to better evaluate the survival benefits. Although PDT is feasible and combines well with clinically used chemotherapeutics, poor tumor specificity has been associated with severe morbidity. The major challenges for both modalities are to increase the tumor specificity of the photosensitizers, to efficiently treat peritoneal microtumors regardless of their phenotypes, and to improve the ability of the excitation light to reach the cancer tissues. Substantial progress has been achieved in (1) the development of targeted photosensitizers and nanocarriers to improve tumor selectivity, (2) the design of biomodulation strategies to reduce treatment heterogeneity, and (3) the development of novel light application strategies. The use of X-ray-activated PDT during whole abdomen radiotherapy may also be considered to overcome the limited tissue penetration of light. Integrated approaches that take advantage of PDD, cytoreductive surgery, chemotherapies, PDT, and potentially radiotherapy, are likely to achieve the most effective improvement in the management of peritoneal carcinomatosis.
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Affiliation(s)
- Si Xu
- Institute for Advanced Biosciences, INSERM U1209, CNRS UMR5309, Université Grenoble-Alpes, 38700 La Tronche, France; (S.X.); (A.H.); (M.B.)
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Anne-Laure Bulin
- Synchrotron Radiation for Biomedicine, UA07 INSERM, Université Grenoble-Alpes, European Synchrotron Radiation Facility, Biomedical Beamline, 38043 Grenoble CEDEX 9, France; (A.-L.B.); (H.E.)
| | - Amandine Hurbin
- Institute for Advanced Biosciences, INSERM U1209, CNRS UMR5309, Université Grenoble-Alpes, 38700 La Tronche, France; (S.X.); (A.H.); (M.B.)
| | - Hélène Elleaume
- Synchrotron Radiation for Biomedicine, UA07 INSERM, Université Grenoble-Alpes, European Synchrotron Radiation Facility, Biomedical Beamline, 38043 Grenoble CEDEX 9, France; (A.-L.B.); (H.E.)
| | - Jean-Luc Coll
- Institute for Advanced Biosciences, INSERM U1209, CNRS UMR5309, Université Grenoble-Alpes, 38700 La Tronche, France; (S.X.); (A.H.); (M.B.)
- Correspondence:
| | - Mans Broekgaarden
- Institute for Advanced Biosciences, INSERM U1209, CNRS UMR5309, Université Grenoble-Alpes, 38700 La Tronche, France; (S.X.); (A.H.); (M.B.)
- Synchrotron Radiation for Biomedicine, UA07 INSERM, Université Grenoble-Alpes, European Synchrotron Radiation Facility, Biomedical Beamline, 38043 Grenoble CEDEX 9, France; (A.-L.B.); (H.E.)
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van den Brand D, van Lith SAM, de Jong JM, Gorris MAJ, Palacio-Castañeda V, Couwenbergh ST, Goldman MRG, Ebisch I, Massuger LF, Leenders WPJ, Brock R, Verdurmen WPR. EpCAM-Binding DARPins for Targeted Photodynamic Therapy of Ovarian Cancer. Cancers (Basel) 2020; 12:E1762. [PMID: 32630661 PMCID: PMC7409335 DOI: 10.3390/cancers12071762] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/30/2020] [Indexed: 12/11/2022] Open
Abstract
Ovarian cancer is the most lethal gynecological malignancy due to late detection associated with dissemination throughout the abdominal cavity. Targeted photodynamic therapy (tPDT) aimed at epithelial cell adhesion molecule (EpCAM), overexpressed in over 90% of ovarian cancer metastatic lesions, is a promising novel therapeutic modality. Here, we tested the specificity and activity of conjugates of EpCAM-directed designed ankyrin repeat proteins (DARPins) with the photosensitizer IRDye 700DX in in vitro and in vivo ovarian cancer models. EpCAM-binding DARPins (Ec1: Kd = 68 pM; Ac2: Kd = 130 nM) and a control DARPin were site-specifically functionalized with fluorophores or IRDye 700DX. Conjugation of anti-EpCAM DARPins with fluorophores maintained EpCAM-specific binding in cell lines and patient-derived ovarian cancer explants. Penetration of DARPin Ec1 into tumor spheroids was slower than that of Ac2, indicative of a binding site barrier effect for Ec1. DARPin-IRDye 700DX conjugates killed EpCAM-expressing cells in a highly specific and illumination-dependent fashion in 2D and 3D cultures. Furthermore, they effectively homed to EpCAM-expressing subcutaneous OV90 xenografts in mice. In conclusion, the high activity and specificity observed in preclinical ovarian cancer models, combined with a high specificity in patient material, warrant a further investigation of EpCAM-targeted PDT for ovarian cancer.
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Affiliation(s)
- Dirk van den Brand
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein 28, 6525 GA Nijmegen, The Netherlands; (D.v.d.B.); (J.M.d.J.); (V.P.-C.); (S.T.C.); (M.R.G.G.); (W.P.J.L.); (R.B.)
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands;
| | - Sanne A. M. van Lith
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands;
| | - Jelske M. de Jong
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein 28, 6525 GA Nijmegen, The Netherlands; (D.v.d.B.); (J.M.d.J.); (V.P.-C.); (S.T.C.); (M.R.G.G.); (W.P.J.L.); (R.B.)
| | - Mark A. J. Gorris
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands;
| | - Valentina Palacio-Castañeda
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein 28, 6525 GA Nijmegen, The Netherlands; (D.v.d.B.); (J.M.d.J.); (V.P.-C.); (S.T.C.); (M.R.G.G.); (W.P.J.L.); (R.B.)
| | - Stijn T. Couwenbergh
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein 28, 6525 GA Nijmegen, The Netherlands; (D.v.d.B.); (J.M.d.J.); (V.P.-C.); (S.T.C.); (M.R.G.G.); (W.P.J.L.); (R.B.)
| | - Mark R. G. Goldman
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein 28, 6525 GA Nijmegen, The Netherlands; (D.v.d.B.); (J.M.d.J.); (V.P.-C.); (S.T.C.); (M.R.G.G.); (W.P.J.L.); (R.B.)
| | - Inge Ebisch
- Department of Obstetrics and Gynaecology, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ Nijmegen, The Netherlands;
| | - Leon F. Massuger
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands;
| | - William P. J. Leenders
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein 28, 6525 GA Nijmegen, The Netherlands; (D.v.d.B.); (J.M.d.J.); (V.P.-C.); (S.T.C.); (M.R.G.G.); (W.P.J.L.); (R.B.)
| | - Roland Brock
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein 28, 6525 GA Nijmegen, The Netherlands; (D.v.d.B.); (J.M.d.J.); (V.P.-C.); (S.T.C.); (M.R.G.G.); (W.P.J.L.); (R.B.)
| | - Wouter P. R. Verdurmen
- Department of Biochemistry, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein 28, 6525 GA Nijmegen, The Netherlands; (D.v.d.B.); (J.M.d.J.); (V.P.-C.); (S.T.C.); (M.R.G.G.); (W.P.J.L.); (R.B.)
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