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Photodynamic therapy for mesothelioma

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Opinion statement

Multiple trials of traditional cancer therapies for malignant pleural mesothelioma (including surgery, radiation therapy, and chemotherapy) have not convincingly demonstrated that any one treatment is superior to supportive care alone. Although there have been reports of long-term survivors who were treated with aggressive surgery combined with radiation and aggressive multi-agent chemotherapeutic regimens, these patient populations are highly selected and results cannot be generalized to a larger population. Despite attempts to use aggressive multimodality therapies, disease recurs in most patients. Local failure in particular is a large part of the natural history of mesothelioma, especially after surgery alone. Therefore, one of the major considerations in the development of new treatments is the inclusion of aggressive local therapies. Photodynamic therapy (PDT), a local treatment modality, is being evaluated as an adjuvant therapy to surgical resection. Clinical use of PDT requires the use of a photosensitizing agent and light of a wavelength specific to the absorption characteristics of the sensitizer in the presence of oxygen. The treatment effect of PDT is superficial, mostly because of the limited depth of light absorption in tissues. Therefore, it is theoretically an ideal treatment for tissue surfaces and body cavities after surgical debulking procedures. One theoretical advantage of PDT is that it can be used to treat the lung surface after a pleurectomy; therefore, patients may be treated with a pleurectomy rather than with an extrapleural pneumonectomy. Several studies have evaluated the efficacy of PDT in the treatment of mesothelioma. Clinical studies have not proven convincingly that the use of PDT is superior to the use of other adjuvant therapies or to surgery alone. The advent of newer photosensitizers and improved laser technology has led to a renewed interest in evaluating PDT. Additional studies are necessary to determine the role of PDT in the treatment of mesothelioma.

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References and Recommended Reading

  1. Antman K, Pass H, Schiff P: Benign and malignant meosthelioma. In Cancer: Principles and Practice of Oncology, edn 5. Edited by DeVita VT, Hellman S, Rosenberg, SA. Philadelphia: Lippincott-Raven Publishers; 1997:1853–1878.

    Google Scholar 

  2. Kindler H, Vogelzang N: Mesothelioma. In Oncologic Therapies. Edited by Vokes E, Golomb H. Berlin: Springer-Verlag; 1999:635.

    Google Scholar 

  3. Baas P, Schouwink H, Zoetmulder FA: Malignant pleural mesothelioma. Ann Oncol 1998, 9:139–149.

    Article  PubMed  CAS  Google Scholar 

  4. Carbone M, Pass HI, Rizzo P, et al.: Simian virus 40-like DNA sequences in human pleural mesothelioma. Oncogene 1994, 9:1781–1790.

    PubMed  CAS  Google Scholar 

  5. Rizzo P, Bocchetta MK, Pass H, et al.:SV40 and the pathogenesis of mesothelioma. Semin Cancer Biol 2001, 11:63–71.

    Article  PubMed  CAS  Google Scholar 

  6. Jasani B, Jones CJ, Radu C, et al.: Simian virus 40 detection in human mesothelioma: reliability and significance of the available molecular evidence. Front Biosci 2001, 6:E12-E22.

    Article  PubMed  CAS  Google Scholar 

  7. Sterman DH, Kaiser LR, Albelda SM: Advances in the treatment of malignant pleural mesothelioma. Chest 1999, 116:504–520. This is a comprehensive review of emerging treatments for mesothelioma.

    Article  PubMed  CAS  Google Scholar 

  8. Sugarbaker DJ, Norberto JJ, Swanson SJ: Extrapleural pneumonectomy in the setting of multimodality therapy for diffuse malignant pleural mesothelioma. Semin Thorac Cardiovasc Surg 1997, 9:373–382.

    PubMed  CAS  Google Scholar 

  9. Maggi G, Casadio C, Cianci R, et al.: Trimodality management of malignant pleural mesothelioma. Eur J Cardiothorac Surg 2001, 19:346–350.

    Article  PubMed  CAS  Google Scholar 

  10. Byrne MJ, Davidson JA, Musk AW, et al.: Cisplatin and gemcitabine treatment for malignant mesothelioma: a phase II study. J Clin Oncol 1999, 17:25–30.

    PubMed  CAS  Google Scholar 

  11. Kindler HL, Millard F, Herndon JE, et al.: Gemcitabine for malignant mesothelioma: a phase II trial by the Cancer and Leukemia Group B. Lung Cancer 2001, 31:311–317.

    Article  PubMed  CAS  Google Scholar 

  12. Oh Y, Perez-Soler R, Fossella FV, et al.: Phase II study of intravenous Doxil in malignant pleural mesothelioma. Invest New Drugs 2000, 18:243–245.

    Article  PubMed  CAS  Google Scholar 

  13. Ong ST, Vogelzang NJ: Chemotherapy in malignant pleural mesothelioma: a review. J Clin Oncol 1996, 14:1007–1017.

    PubMed  CAS  Google Scholar 

  14. Vogelzang NJ, Goutsou M, Corson JM, et al.: Carboplatin in malignant mesothelioma: a phase II study of the Cancer and Leukemia Group B. Cancer Chemother Pharmacol 1990, 27:239–242.

    Article  PubMed  CAS  Google Scholar 

  15. Chahinian AP, Antman K, Goutsou M, et al.: Randomized phase II trial of cisplatin with mitomycin or doxorubicin for malignant mesothelioma by the Cancer and Leukemia Group B. J Clin Oncol 1993, 11:1559–1565.

    PubMed  CAS  Google Scholar 

  16. Stam TC, Swaak AJ, Kruit WH, et al.: Intrapleural administration of tumour necrosis factor-alpha (TNFalpha) in patients with mesothelioma: cytokine patterns and acute-phase protein response. Eur J Clin Invest 2000, 30:336–343.

    Article  PubMed  CAS  Google Scholar 

  17. Figlin R, Mendoza E, Piantadosi S, Rusch V: Intrapleural chemotherapy without pleurodesis for malignant pleural effusions. Chest 1994, 106:363S-366S.

    PubMed  CAS  Google Scholar 

  18. Kindler H: Malignant pleural mesothelioma. Curr Treat Opt Oncol 2000, 1:313–326.

    CAS  Google Scholar 

  19. Davis SR, Tan L, Ball DL: Radiotherapy in the treatment of malignant mesothelioma of the pleura, with special reference to its use in palliation. Australas Radiol 1994, 38:212–214.

    PubMed  CAS  Google Scholar 

  20. Gomer C, Dougherty T: Determination of [3H]- and [14C] hematoporphyrin derivative distribution in malignant and normal tissue. Cancer Res 1979, 39:146–151.

    PubMed  CAS  Google Scholar 

  21. Young SW, Woodburn KW, Wright M, et al.: Lutetium texaphyrin (PCI-0123) a near-infrared, water-soluble photosensitizer. Photochem Photobiol 1996, 63:892–897.

    PubMed  CAS  Google Scholar 

  22. Berenbaum MC, Akande SL, Bonnett R, et al.: Meso-Tetra(hydroxyphenyl)porphyrins, a new class of potent tumour photosensitisers with favourable selectivity. Br J Cancer 1986, 54:717–725.

    PubMed  CAS  Google Scholar 

  23. DoughertyTJ, Gomer CJ, Henderson BW, et al.: Photodynamic therapy [review]. J Natl Cancer Inst 1998, 90:889–905. This is an excellent comprehensive review, detailing the scientific, clinical, and technical aspects of PDT.

    Article  PubMed  CAS  Google Scholar 

  24. Pass HI: Photodynamic therapy in oncology: mechanisms and clinical use. J Natl Cancer Inst 1993, 85:443–456.

    Article  PubMed  CAS  Google Scholar 

  25. Foote CS: Mechanisms of photooxygenation. Prog Clin Biol Res 1984, 170:3–18.

    PubMed  CAS  Google Scholar 

  26. Gomer CJ, Rucker N, Banerjee A, et al.: Comparison of mutagenicity and induction of sister chromatid exchange in Chinese hamster cells exposed to hematoporphyrin derivative photoradiation, ionizing radiation, or ultraviolet radiation. Cancer Res 1983, 43:2622–2627.

    PubMed  CAS  Google Scholar 

  27. Hahn S, Glatstein E: The emergence of photodynamic therapy as a major modality in cancer treatment. Rev Contemp Pharmocother 1999, 10:69–74.

    CAS  Google Scholar 

  28. Murrer L, Marijnissen J, Baas P, et al.: Applicator for light delivery and in situ light dosimetry during endobronchial photodynamic therapy: first measurements in humans. Lasers Med Sci 1997, 12:253–259.

    CAS  PubMed  Google Scholar 

  29. Tan IB, Oppelaar H, Ruevekamp MC, et al.: The importance of in situ light dosimetry for photodynamic therapy of oral cavity tumors. Head Neck 1999, 21:434–441.

    Article  PubMed  CAS  Google Scholar 

  30. Baas P, Murrer L, Zoetmulder FA, et al.: Photodynamic therapy as adjuvant therapy in surgically treated pleural malignancies. Br J Cancer 1997, 76:819–826. This study reports a clinical trial of Foscan mediated PDT for pleural malignancies. A novel light dosimetry system is discussed.

    PubMed  CAS  Google Scholar 

  31. Ris H, Altermatt H, Nachbur B, et al.: Intraoperative photodynamic therapy with m-tetrahydroxyphenylchlorin for chest malignancies. Lasers Surg Med 1996, 18:39–45.

    Article  PubMed  CAS  Google Scholar 

  32. Wieman T, Panella T, Lustig R, et al.: Photodynamic therapy (PDT) of locally recurrent breast cancer (LRBC) with lutetium texaphyrin (Lutrin): a phase IB/IIA trial [abstract]. Proc ASCO 1999, 18:111a.

    Google Scholar 

  33. Yuen A, Panella T, Wieman T, et al.: Phase I trial of photodynamic therapy with lutetium-texaphyrin (LU-TEX) [abstract]. Proc ASCO 1997, 16:219a.

    Google Scholar 

  34. Sugarbaker DJ, Mentzer SJ, Strauss G: Extrapleural pneumonectomy in the treatment of malignant pleural mesothelioma. Ann Thorac Surg 1992, 54:941–946. An excellent report that provides the details of the surgical treatment of mesothelioma.

    Article  PubMed  CAS  Google Scholar 

  35. Takita H, Mang TS, Loewen GM, et al.: Operation and intracavitary photodynamic therapy for malignant pleural mesothelioma: a phase II study. Ann Thorac Surg 1994, 58:995–998.

    Article  PubMed  CAS  Google Scholar 

  36. Moskal TL, Dougherty TJ, Urschel JD, et al.: Operation and photodynamic therapy for pleural mesothelioma: 6-year follow-up. Ann Thorac Surg 1998, 66:1128–33.

    Article  PubMed  CAS  Google Scholar 

  37. Pass HI, DeLaney TF, Tochner Z, et al.: Intrapleural photodynamic therapy: results of a phase I trial. Ann Surg Oncol 1994, 1:28–37. This is a report of a well-designed and performed phase I trial of Photofrin mediated PDT.

    Article  PubMed  CAS  Google Scholar 

  38. PassHI, Temeck BK, Kranda K, et al.: Phase III randomized trial of surgery with or without intraoperative photodynamic therapy and postoperative immunochemotherapy for malignant pleural mesothelioma. Ann Surg Oncol 1997, 4:628–633. This is a report of the only randomized phase III trial of PDT for the treatment of mesothelioma.

    Article  PubMed  CAS  Google Scholar 

  39. Ris HB, Altermatt HJ, Inderbitzi R, et al.: Photodynamic therapy with chlorins for diffuse malignant mesothelioma: initial clinical results. Br J Cancer 1991, 64:1116–1120.

    PubMed  CAS  Google Scholar 

  40. Kindler H, Vogelzang N, Chien K, et al.: SU5416 in malignant mesothelioma: a university of chicago phase II consortium study [abstract]. Proc ASCO 2001, 20:341a.

    Google Scholar 

  41. Ferrario A, von Tiehl KF, Rucker N, et al.: Antiangiogenic treatment enhances photodynamic therapy responsiveness in a mouse mammary carcinoma. Cancer Res 2000, 60:4066–4469.

    PubMed  CAS  Google Scholar 

  42. Dimitroff CJ, Klohs W, Sharma A, et al.: Anti-angiogenic activity of selected receptor tyrosine kinase inhibitors, PD166285 and PD173074: implications for combination treatment with photodynamic therapy. Invest New Drugs 1999, 17:121–135.

    Article  PubMed  CAS  Google Scholar 

  43. Boutin C, Viallat JR, Van Zandwijk N, et al.: Activity of intrapleural recombinant gamma-interferon in malignant mesothelioma. Cancer 1991, 67:2033–2037.

    Article  PubMed  CAS  Google Scholar 

  44. Korbelik M, Dougherty GJ: Photodynamic therapymediated immune response against subcutaneous mouse tumors. Cancer Res 1999, 59:1941–1946.

    PubMed  CAS  Google Scholar 

  45. Korbelik M, Cecic I: Contribution of myeloid and lymphoid host cells to the curative outcome of mouse sarcoma treatment by photodynamic therapy. Cancer Lett 1999, 137:91–98.

    Article  PubMed  CAS  Google Scholar 

  46. Korbelik M: Induction of tumor immunity by photodynamic therapy. J Clin Laser Med Surg 1996, 14:329–334.

    PubMed  CAS  Google Scholar 

  47. Korbelik M, Cecic I: Enhancement of tumour response to photodynamic therapy by adjuvant mycobacterium cell-wall treatment. J Photochem Photobiol B 1998, 44:151–158.

    Article  PubMed  CAS  Google Scholar 

  48. Korbelik M, Sun J, Posakony JJ: Interaction between photodynamic therapy and BCG immunotherapy responsible for the reduced recurrence of treated mouse tumors. Photochem Photobiol 2001, 73:403–409.

    Article  PubMed  CAS  Google Scholar 

  49. Korbelik M, Naraparaju VR, Yamamoto N: Macrophagedirected immunotherapy as adjuvant to photodynamic therapy of cancer. Br J Cancer 1997, 75:202–207.

    PubMed  CAS  Google Scholar 

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  1. Department of Radiation Oncology, University of Pennsylvania, 2 Donner, 3400 Spruce Street, 19104-4283, Philadelphia, PA, USA

    Stephen M. Hahn MD, Ryan P. Smith MD & Joseph Friedberg MD

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Hahn, S.M., Smith, R.P. & Friedberg, J. Photodynamic therapy for mesothelioma. Curr. Treat. Options in Oncol. 2, 375–383 (2001). https://doi.org/10.1007/s11864-001-0042-4

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