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Br J Cancer. 2014 Apr 2;110(7):1698-704. doi: 10.1038/bjc.2014.95. Epub 2014 Feb 25.

Phase I/II study of verteporfin photodynamic therapy in locally advanced pancreatic cancer.

Author information

  • 1UCL Institute for Liver and Digestive Health, University College London, UCL Medical School-Royal Free Hospital Campus, U3 Floor, Pond Street, London NW3 2QG, UK.
  • 2Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA.
  • 3Department of Radiology, University College Hospital, London, UK.
  • 4National Medical Laser Centre, University College London, London, UK.
  • 5Department of Pathology, University College Hospital, London, UK.
  • 6UCLH Cancer Clinical Trials Unit, University College Hospital, London, UK.
  • 7Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA.

Abstract

BACKGROUND:

Patients with pancreatic cancer have a poor prognosis apart from the few suitable for surgery. Photodynamic therapy (PDT) produces localised tissue necrosis but previous studies using the photosensitiser meso-tetrahydroxyphenylchlorin (mTHPC) caused prolonged skin photosensitivity. This study assessed a shorter acting photosensitiser, verteporfin.

METHODS:

Fifteen inoperable patients with locally advanced cancers were sensitised with 0.4 mg kg(-1) verteporfin. After 60-90 min, laser light (690 nm) was delivered via single (13 patients) or multiple (2 patients) fibres positioned percutaneously under computed tomography (CT) guidance, the light dose escalating (initially 5 J, doubling after each three patients) until 12 mm of necrosis was achieved consistently.

RESULTS:

In all, 12 mm lesions were seen consistently at 40 J, but with considerable variation in necrosis volume (mean volume 3.5 cm(3) at 40 J). Minor, self-limiting extrapancreatic effects were seen in multifibre patients. No adverse interactions were seen in patients given chemotherapy or radiotherapy before or after PDT. After PDT, one patient underwent an R0 Whipple's pancreaticoduodenectomy.

CONCLUSIONS:

Verteporfin PDT-induced tumour necrosis in locally advanced pancreatic cancer is feasible and safe. It can be delivered with a much shorter drug light interval and with less photosensitivity than with older compounds.

PMID:
24569464
PMCID:
PMC3974098
DOI:
10.1038/bjc.2014.95
[PubMed - indexed for MEDLINE]
Free PMC Article
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