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Photodynamic therapy for cancer of the pancreas – The story so far

  • Stephen G. Bown EMAIL logo
Veröffentlicht/Copyright: 6. April 2016
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Photonics & Lasers in Medicine
Aus der Zeitschrift Photonics & Lasers in Medicine Band 5 Heft 2

Abstract

Background and objective: Pancreatic cancer has long been a leading cause of cancer death. Few patients are suitable for surgery and for those who are not, the response to treatment is generally poor. No more than about 10% survive for more than a year. Recent research has focused on focal treatment for local disease control. This review covers the development of one of the most promising options, photodynamic therapy (PDT).

Methods: This review covers pre-clinical and clinical studies. Laboratory work was designed to understand the effect of PDT on the normal pancreas and surrounding tissues and on transplanted cancers in the hamster pancreas to ensure safety prior to clinical application. Essentially all clinical studies have been undertaken in University College Hospital, London. Phase-I studies used the photosensitisers mTHPC and verteporfin in patients with localised but inoperable cancers.

Results: Laboratory results showed that normal pancreas, bile duct, liver, stomach and major blood vessels could tolerate PDT without any unacceptable effects on the structure and function of these organs. Necrosis that healed safely was documented in transplanted cancers. The clinical trials showed that focal necrosis could be produced in inoperable cancers with acceptable levels of complications, but considerable refinements of treatment delivery and monitoring are required before the technique will be ready for assessment in controlled clinical trials.

Conclusions: PDT is showing promise for the minimally invasive treatment of localised pancreatic cancers, but it is still at an early stage of development. Much more work will be necessary to optimise techniques for applying PDT to these cancers and for combining it with other therapeutic options such as chemotherapy.

Zusammenfassung

Hintergrund und Zielsetzung: Bauchspeicheldrüsenkrebs gehört seit langem zu den am häufigsten zum Tode führenden Krebserkrankungen. Nur wenige Patienten sind für einen chirurgischen Eingriff geeignet und die, die es nicht sind, haben in der Regel eine schlechte Prognose. Nicht mehr als etwa 10% überleben für mehr als ein Jahr. Die neuere Forschung hat sich bei der Krankheitsbekämpfung auf fokale Behandlungsformen konzentriert. Die vorliegende Arbeit fokussiert sich auf die Entwicklung einer der vielversprechendsten Optionen, die Photodynamische Therapie (PDT).

Methoden: Das vorliegende Review umfasst sowohl präklinische als auch klinische Studien. Laboruntersuchungen wurden durchgeführt, um zunächst die Wirkung der PDT auf die normale Bauchspeicheldrüse und das umgebende Gewebe sowie auf transplantierte Tumoren im Hamstermodell zu verstehen, um so die Sicherheit im Vorfeld klinischer Anwendungen zu gewährleisten. Im Wesentlichen wurden alle klinischen Studien im University College Hospital, London durchgeführt. In Phase-I-Studien wurden die Photosensibilisatoren mTHPC und Verteporfin bei Patienten mit lokal begrenztem, aber inoperablem Krebs angewendet.

Ergebnisse: Die Laborergebnisse zeigten, dass normales Gewebe von Bauchspeicheldrüse, Gallengang, Leber, und Magen sowie große Blutgefäße eine PDT ohne inakzeptable Auswirkungen auf die Struktur und Funktion dieser Organe tolerieren kann. Nekrosen, die sicher heilten, wurden in transplantierten Tumoren dokumentiert. Die klinischen Studien haben gezeigt, dass fokale Nekrosen bei inoperablen Tumoren mit tolerablen Komplikationen erzeugt werden können, aber eine erhebliche Verbesserung der Behandlung und Überwachung erforderlich sind, bevor die Technik in kontrollierten klinischen Studien weiter beurteilt werden kann.

Schlussfolgerungen: Die PDT stellt eine vielversprechende minimal-invasive Behandlungsoption bei lokalisiertem Bauchspeicheldrüsenkrebs dar, befindet sich aber noch in einem frühen Entwicklungsstadium. Mehr Forschungsarbeit ist notwendig, um die für die PDT erforderlichen Techniken für diese Krebsart zu optimieren und die PDT mit anderen therapeutischen Optionen, wie der Chemotherapie, kombinieren zu können.

Keywords: biology of photodynamic therapy (PDT); translational studies of PDT for pancreatic cancer
Schlüsselwörter:: Biologie der Photodynamischen Therapy (PDT); translationale Studien zur PDT von Bauchspeicheldrüsenkrebs

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Received: 2016-1-28
Revised: 2016-2-29
Accepted: 2016-3-1
Published Online: 2016-4-6
Published in Print: 2016-5-1

©2016 by De Gruyter

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. From optical bioimaging to clinical biophotonics
  4. Magazine section
  5. Snapshots
  6. Review
  7. Photodynamic therapy for cancer of the pancreas – The story so far
  8. Original contributions
  9. Fluorescence imaging for photodynamic therapy of non-melanoma skin malignancies – A retrospective clinical study
  10. Hydrogen peroxide detection in viable and apoptotic tumor cells under action of cisplatin and bleomycin
  11. Light enhancement of in vitro antitumor activity of galactosylated phthalocyanines
  12. Investigation on cavitation bubble dynamics induced by clinically available Ho:YAG lasers
  13. Preliminary research reports
  14. Enhancement of OCT imaging by blood optical clearing in vessels – A feasibility study
  15. Effect of temperature regime and compression in OCT imaging of skin in vivo
  16. Congress announcements
  17. Congresses 2016
https://doi.org/10.1515/plm-2016-0001
Schlagwörter für diesen Artikel
biology of photodynamic therapy (PDT); translational studies of PDT for pancreatic cancer

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. From optical bioimaging to clinical biophotonics
  4. Magazine section
  5. Snapshots
  6. Review
  7. Photodynamic therapy for cancer of the pancreas – The story so far
  8. Original contributions
  9. Fluorescence imaging for photodynamic therapy of non-melanoma skin malignancies – A retrospective clinical study
  10. Hydrogen peroxide detection in viable and apoptotic tumor cells under action of cisplatin and bleomycin
  11. Light enhancement of in vitro antitumor activity of galactosylated phthalocyanines
  12. Investigation on cavitation bubble dynamics induced by clinically available Ho:YAG lasers
  13. Preliminary research reports
  14. Enhancement of OCT imaging by blood optical clearing in vessels – A feasibility study
  15. Effect of temperature regime and compression in OCT imaging of skin in vivo
  16. Congress announcements
  17. Congresses 2016
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