Ayaru Lakshmana, Wittmann Johannes, Macrobert A J, Novelli Marco, Bown Stephen G, Pereira Stephen P
The UCL Institute of Hepatology, Department of Medicine, Royal Free and University College London Medical School, University College London, London, UK.
Pancreatology. 2007;7(1):20-7. doi: 10.1159/000101874. Epub 2007 Apr 18.
BACKGROUND/AIM: Photodynamic therapy (PDT) is a potential treatment for locally advanced pancreatic cancer. We aimed to assess the safety of interstitial PDT using verteporfin (benzoporphyrin derivative monoacid A - a novel photosensitizer with a short drug-light interval and limited cutaneous photosensitivity) in the Syrian golden hamster, and compare it to meso-tetrahydroxyphenylchlorin (mTHPC) which we have previously evaluated in preclinical and clinical studies.
Verteporfin (2 mg/kg) was administered at laparotomy by inferior vena caval injection (n = 57), with plasma levels quantified at 5, 15, 30, 60 and 240 min, and 24 h. 15 min after photosensitization, tissues (liver, pancreas, duodenum, colon, aorta) were illuminated with 690 nm red laser light (150 mW), at a range of light doses (1-100 J/cm(2)). The PDT effects on the targeted organ and adjacent structures were assessed at post-mortem on days 3 and 21, or at the time of death.
The elimination half-life of verteporfin was 4-5 h. Light doses of 10, 25 and 50 J/cm(2) were safe in the hamster pancreas, liver and colon, respectively, and produced coagulative necrotic lesions of 3 (range 3-4), 10 (9-10) and 7 (7-8) mm diameter. Collagen was resistant to damage and lesions healed mainly by regeneration of normal tissue. At higher light doses, necrosis extended to the edge of organs, sometimes causing sealed duodenal perforations as seen with mTHPC.
The safety profile of verteporfin is very similar to mTHPC, with the advantages of a shorter drug-light interval and drug elimination time. Phase I clinical studies using this photosensitizer in pancreatic cancer should be feasible.
背景/目的:光动力疗法(PDT)是局部晚期胰腺癌的一种潜在治疗方法。我们旨在评估在叙利亚金黄地鼠中使用维替泊芬(苯并卟啉衍生物单酸A——一种新型光敏剂,药物-光照间隔短且皮肤光敏性有限)进行间质光动力疗法的安全性,并将其与我们之前在临床前和临床研究中评估过的中-四羟基苯基氯卟啉(mTHPC)进行比较。
在剖腹手术时通过下腔静脉注射给予维替泊芬(2 mg/kg)(n = 57),并在5、15、30、60和240分钟以及24小时时对血浆水平进行定量。光敏化15分钟后,用690 nm红色激光(150 mW)以一系列光剂量(1 - 100 J/cm²)照射组织(肝脏、胰腺、十二指肠、结肠、主动脉)。在第3天和第21天或死亡时进行尸检,评估光动力疗法对靶器官和相邻结构的影响。
维替泊芬的消除半衰期为4 - 5小时。光剂量分别为10、25和50 J/cm²时,对仓鼠的胰腺、肝脏和结肠是安全的,并产生直径为3(范围3 - 4)、10(9 - 10)和7(7 - 8)mm的凝固性坏死病变。胶原蛋白对损伤有抵抗力,病变主要通过正常组织再生愈合。在较高光剂量下,坏死扩展到器官边缘,有时会导致如mTHPC所见的十二指肠封闭穿孔。
维替泊芬的安全性概况与mTHPC非常相似,具有药物-光照间隔和药物消除时间较短的优点。使用这种光敏剂进行胰腺癌的I期临床研究应该是可行的。