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Clinical Practice of Photodynamic Therapy for Cancers: Latest Advances and Prospects

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 16121

Special Issue Editors

Prof. Dr. Yasuo Murai

E-Mail Website
Guest Editor
Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
Interests: cerebral aneurysm; moyamoya disease; meningioma; RNF 213; exoscope; intracerebral hemorrhage
Special Issues, Collections and Topics in MDPI journals
Dr. Waseem Jerjes

E-Mail Website
Guest Editor
1. Research and Development Unit, Hammersmith and Fulham Primary Care Network, London, UK
2. Faculty of Medicine, Imperial College London, London, UK
Interests: minor surgery; head and neck; photodiagnosis; photodynamic therapy; tissue healing
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The application of photodynamic therapy (PDT) has been successful in the management of several pre-cancers and cancers. It is fundamental to the success of photodynamic therapy that tumour margins are accessed and illuminated and the depth of necrosis is greater than the depth of each individual lesion.
The growing body of evidence regarding PDT’s efficacy suggests that it will have a leading role in minimally invasive surgical oncology. Long-term studies showed that the outcome improves when PDT is offered on a repeatable basis rather than one time only.
Response and outcome are expected to vary among different pathologies, and might depend on the structure, volume, and severity of the pathology. It is worth acknowledging that response to PDT varies among patients suffering from the same grade of the same disease.
The success of the accurate application of PDT now gives rise to the question of whether the application of this technology should be extended to other clinical areas and earlier disease states. A multidisciplinary team that works together is essential to the efficient modern management of local and/or advanced pathologies.
This Special Issue aims to present current advances in photodynamic therapy for managing pre-cancerous and cancerous conditions affecting various anatomical locations. It also aims to look into the developing role of photodynamic therapy in multidisciplinary oncological care.

Prof. Jiro Akimoto
Dr. Waseem Jerjes
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • photodynamic therapy
  • photosensitisers
  • pre-cancer
  • cancer
  • malignancy
  • oncology

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Published Papers (5 papers)

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Research

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10 pages, 636 KiB  
Communication
Photodynamic Therapy with 5-Aminolevulinic Acid Patch for the Treatment of Actinic Keratosis
by Norbert Kiss, Klára Farkas, Giulio Tosti, Federico De Gado, Beata Bergler-Czop, Gilda Fazia, Antonella Tammaro and Carmen Cantisani
J. Clin. Med. 2022, 11(11), 3164; https://doi.org/10.3390/jcm11113164 - 2 Jun 2022
Cited by 4 | Viewed by 2843
Abstract
Photodynamic therapy (PDT) using 5-aminolevulinic acid (5-ALA) is an emerging treatment option in the care of actinic keratosis (AK). A self-adhesive 5-ALA patch was recently developed that allows a precise PDT procedure. Here, we review the current literature and report the findings of [...] Read more.
Photodynamic therapy (PDT) using 5-aminolevulinic acid (5-ALA) is an emerging treatment option in the care of actinic keratosis (AK). A self-adhesive 5-ALA patch was recently developed that allows a precise PDT procedure. Here, we review the current literature and report the findings of our case series that observed the outcomes and safety of 5-ALA patch PDT. Ten patients with a total of 40 AKs were treated with a single session of conventional or daylight PDT using 5-ALA patch at the Department of Dermatology and Venereology, Sapienza University of Rome or at the European Institute of Oncology, Milan, Italy. Complete response was observed in three patients, while partial response was seen in seven patients. Overall tolerability was good or excellent, with local adverse events observed in four patients. This is the first case series reported where the 5-ALA patch was applied using daylight PDT, and its efficacy and tolerability in the treatment of AK were demonstrated. In conclusion, the self-adhesive 5-ALA patch is a convenient application of PDT that provides a well-tolerated and effective treatment option with satisfactory cosmetic outcomes. Full article
(This article belongs to the Special Issue Clinical Practice of Photodynamic Therapy for Cancers: Latest Advances and Prospects)
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11 pages, 551 KiB  
Article
Transurethral Resection of Non-Muscle Invasive Bladder Tumors Combined with Fluorescence Diagnosis and Photodynamic Therapy with Chlorin e6-Type Photosensitizers
by Andrey V. Kustov, Nataliya L. Smirnova, Oleg A. Privalov, Tatyana M. Moryganova, Alexander I. Strelnikov, Philipp K. Morshnev, Oscar I. Koifman, Alex V. Lyubimtsev, Tatyana V. Kustova and Dmitry B. Berezin
J. Clin. Med. 2022, 11(1), 233; https://doi.org/10.3390/jcm11010233 - 31 Dec 2021
Cited by 20 | Viewed by 3172
Abstract
Bladder cancer is a common disease with a high recurrence rate. In order to improve the treatment of superficial bladder tumors, we evaluated the efficacy and safety of transurethral resection (TURB) followed by fluorescence diagnosis (FD) and photodynamic therapy (PDT) with chlorin e [...] Read more.
Bladder cancer is a common disease with a high recurrence rate. In order to improve the treatment of superficial bladder tumors, we evaluated the efficacy and safety of transurethral resection (TURB) followed by fluorescence diagnosis (FD) and photodynamic therapy (PDT) with chlorin e6 photosensitizers (PSs), viz. “Fotoran e6” and “Fotoditazin”. It was found that both PSs generated singlet oxygen and revealed moderate affinity toward the lipid-like compartment. Between November 2018 and October 2020, 12 patients with verified non-muscle invasive bladder cancer (NMIBC) were treated by TURB combined with FD and PDT. Eight patients received “Fotoran e6” intravenously, while four patients received intravesical PSs. The patient ages were between 31 and 79 years, with a median age of 64.5 years (mean 61.3 ± 14.2). The total light dose was 150 J/cm2 for the local irradiation of the tumor bed with a red light at the λ = 660 nm wavelength, and 10–25 J/cm2 were additionally delivered for diffuse irradiation of the entire bladder mucosa. At the median follow-up period of 24 months (mean 24.5 ± 5.4 months, range 16–35 months), 11 patients remained tumor-free. One 79-year-old patient developed a recurrence without progression to the muscle layer. This pilot study shows that the TURB + FD + PDT technique is an effective and safe option for the first-line treatment of superficial bladder tumors. Full article
(This article belongs to the Special Issue Clinical Practice of Photodynamic Therapy for Cancers: Latest Advances and Prospects)
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13 pages, 4449 KiB  
Article
Preliminary Report: Rapid Intraoperative Detection of Residual Glioma Cell in Resection Cavity Walls Using a Compact Fluorescence Microscope
by Jiro Akimoto, Shinjiro Fukami, Megumi Ichikawa, Kenta Nagai and Michihiro Kohno
J. Clin. Med. 2021, 10(22), 5375; https://doi.org/10.3390/jcm10225375 - 18 Nov 2021
Cited by 3 | Viewed by 1818
Abstract
Objective: The surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain–tumor interface (BTI) is crucial for achieving satisfactory clinical results. The usefulness of fluorescence–guided resection for the treatment of malignant glioma was [...] Read more.
Objective: The surgical eradication of malignant glioma cells is theoretically impossible. Therefore, reducing the number of remaining tumor cells around the brain–tumor interface (BTI) is crucial for achieving satisfactory clinical results. The usefulness of fluorescence–guided resection for the treatment of malignant glioma was recently reported, but the detection of infiltrating tumor cells in the BTI using a surgical microscope is not realistic. Therefore, we have developed an intraoperative rapid fluorescence cytology system, and exploratorily evaluated its clinical feasibility for the management of malignant glioma. Materials and methods: A total of 25 selected patients with malignant glioma (newly diagnosed: 17; recurrent: 8) underwent surgical resection under photodiagnosis using photosensitizer Talaporfin sodium and a semiconductor laser. Intraoperatively, a crush smear preparation was made from a tiny amount of tumor tissue, and the fluorescence emitted upon 620/660 nm excitation was evaluated rapidly using a compact fluorescence microscope in the operating theater. Results: Fluorescence intensities of tumor tissues measured using a surgical microscope correlated with the tumor cell densities of tissues evaluated by measuring the red fluorescence emitted from the cytoplasm of tumor cells using a fluorescence microscope. A “weak fluorescence” indicated a reduction in the tumor cell density, whereas “no fluorescence” did not indicate the complete eradication of the tumor cells, but indicated that few tumor cells were emitting fluorescence. Conclusion: The rapid intraoperative detection of fluorescence from glioma cells using a compact fluorescence microscope was probably useful to evaluate the presence of tumor cells in the resection cavity walls, and could provide surgical implications for the more complete resection of malignant gliomas. Full article
(This article belongs to the Special Issue Clinical Practice of Photodynamic Therapy for Cancers: Latest Advances and Prospects)
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Review

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9 pages, 998 KiB  
Review
Clinical Practice of Photodynamic Therapy Using Talaporfin Sodium for Esophageal Cancer
by Tomonori Yano, Tatsunori Minamide, Kenji Takashima, Keiichiro Nakajo, Tomohiro Kadota and Yusuke Yoda
J. Clin. Med. 2021, 10(13), 2785; https://doi.org/10.3390/jcm10132785 - 24 Jun 2021
Cited by 41 | Viewed by 3006
Abstract
Photodynamic therapy (PDT) using a conventional photosensitizer was approved for esophageal cancer in the early 1990s; however, it was replaced by other conventional treatment modalities in clinical practice because of the high frequency of cutaneous phototoxicity and esophageal stricture after the procedure. The [...] Read more.
Photodynamic therapy (PDT) using a conventional photosensitizer was approved for esophageal cancer in the early 1990s; however, it was replaced by other conventional treatment modalities in clinical practice because of the high frequency of cutaneous phototoxicity and esophageal stricture after the procedure. The second-generation photosensitizer, talaporfin sodium, which features more rapid clearance from the body, was developed to reduce skin phototoxicity, and talaporfin sodium can be excited at longer-wavelength lights comparing with a conventional photosensitizer. Endoscopic PDT using talaporfin sodium was initially developed for the curative treatment of central-type early lung cancer in Japan, and was approved in the early 2000s. After preclinical experiments, PDT using talaporfin sodium was investigated for patients with local failure after chemoradiotherapy, which was the most serious unmet need in the practice of esophageal cancer. According to the favorable results of a multi-institutional clinical trial, PDT using talaporfin sodium was approved as an endoscopic salvage treatment for patients with local failure after chemoradiotherapy for esophageal cancer. While PDT using talaporfin sodium is gradually spreading in clinical practice, further evaluation at the point of clinical benefit is necessary to determine the importance of PDT in the treatment of esophageal cancer. Full article
(This article belongs to the Special Issue Clinical Practice of Photodynamic Therapy for Cancers: Latest Advances and Prospects)
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14 pages, 1973 KiB  
Review
Potential of Photodynamic Therapy Based on Sugar-Conjugated Photosensitizers
by Hiromi Kataoka, Hirotada Nishie, Mamoru Tanaka, Makiko Sasaki, Akihiro Nomoto, Tomohiro Osaki, Yoshiharu Okamoto and Shigenobu Yano
J. Clin. Med. 2021, 10(4), 841; https://doi.org/10.3390/jcm10040841 - 18 Feb 2021
Cited by 22 | Viewed by 3714
Abstract
In 2015, the Japanese health insurance approved the use of a second-generation photodynamic therapy (PDT) using talaporfin sodium (TS); however, its cancer cell selectivity and antitumor effects of TS PDT are not comprehensive. The Warburg effect describes the elevated rate of glycolysis in [...] Read more.
In 2015, the Japanese health insurance approved the use of a second-generation photodynamic therapy (PDT) using talaporfin sodium (TS); however, its cancer cell selectivity and antitumor effects of TS PDT are not comprehensive. The Warburg effect describes the elevated rate of glycolysis in cancer cells, despite the presence of sufficient oxygen. Because cancer cells absorb considerable amounts of glucose, they are visible using positron emission tomography (PET). We developed a third-generation PDT based on the Warburg effect by synthesizing novel photosensitizers (PSs) in the form of sugar-conjugated chlorins. Glucose-conjugated (tetrafluorophenyl) chlorin (G-chlorin) PDT revealed significantly stronger antitumor effects than TS PDT and induced immunogenic cell death (ICD). ICD induced by PDT enhances cancer immunity, and a combination therapy of PDT and immune checkpoint blockers is expected to synergize antitumor effects. Mannose-conjugated (tetrafluorophenyl) chlorin (M-chlorin) PDT, which targets cancer cells and tumor-associated macrophages (TAMs), also shows strong antitumor effects. Finally, we synthesized a glucose-conjugated chlorin e6 (SC-N003HP) that showed 10,000–50,000 times stronger antitumor effects than TS (IC50) in vitro, and it was rapidly metabolized and excreted. In this review, we discuss the potential and the future of next-generation cancer cell-selective PDT and describe three types of sugar-conjugated PSs expected to be clinically developed in the future. Full article
(This article belongs to the Special Issue Clinical Practice of Photodynamic Therapy for Cancers: Latest Advances and Prospects)
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