Munegowda Manjunatha Akathatti, Fisher Carl, Molehuis Daniel, Foltz Warren, Roufaiel Mark, Bassan Jay, Nitz Mark, Mandel Arkady, Lilge Lothar
Theralase Technologies Inc., Toronto, Ontario, Canada.
Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Neurooncol Adv. 2019 May 28;1(1):vdz006. doi: 10.1093/noajnl/vdz006. eCollection 2019 May-Dec.
Glioblastoma is an aggressive brain cancer in adults with a grave prognosis, aggressive radio and chemotherapy provide only a 15 months median survival.
We evaluated the tolerability and efficacy of the Ruthenium-based photosensitizer TLD-1433 with apo-Transferrin (Rutherrin) in the rat glioma 2 (RG-2) model. The specific tumor uptake ratio and photodynamic therapy (PDT) threshold of the rat glioblastoma and normal brain were determined, survival and CD8T-cell infiltration post-therapy were analyzed. Results were compared with those obtained for 5-aminolevulinic acid (ALA)-induced Protoporphyrin IX (PpIX)-mediated photodynamic therapy in the same animal model. As both photosensitizers have different photophysical properties, the number of absorbed photons required to achieve an equal cell kill was determined for in vitro and in vivo studies.
A significantly lower absorbed energy was sufficient to achieve LD with Rutherrin versus PpIX-mediated PDT. Rutherrin provides a higher specific uptake ratio (SUR) >20 in tumors versus normal brain, whereas the SUR for ALA-induced PpIX was 10.6. To evaluate the short-term tissue response in vivo, enhanced T2-weighted magnetic resonance imaging (MRI) provided the spatial extent of edema, post PpIX-PDT at twice the cross-section versus Rutherrin-PDT suggesting reduced nonspecific damage, typically associated with a secondary wave of neuronal damage. Following a single therapy, a significant survival increase was observed in rats bearing glioma for PDT mediated by Rutherrin versus PpIX for the selected treatment conditions. Rutherrin-PDT also demonstrated an increased CD8+T-cell infiltration in the tumors.
Rutherrin-PDT was well tolerated providing a safe and effective treatment of RG-2 glioma.
胶质母细胞瘤是成人侵袭性脑癌,预后严重,积极的放疗和化疗仅能提供15个月的中位生存期。
我们在大鼠胶质瘤2(RG-2)模型中评估了钌基光敏剂TLD-1433与脱铁转铁蛋白(Rutherrin)的耐受性和疗效。测定了大鼠胶质母细胞瘤和正常脑的特异性肿瘤摄取率和光动力疗法(PDT)阈值,分析了治疗后的生存期和CD8T细胞浸润情况。将结果与在同一动物模型中5-氨基酮戊酸(ALA)诱导的原卟啉IX(PpIX)介导的光动力疗法的结果进行比较。由于两种光敏剂具有不同的光物理性质,因此在体外和体内研究中确定了实现同等细胞杀伤所需的吸收光子数。
与PpIX介导的PDT相比,Rutherrin实现致死剂量所需的吸收能量显著更低。Rutherrin在肿瘤中的特异性摄取率(SUR)>20,而正常脑的SUR为20,而ALA诱导的PpIX的SUR为10.6。为了评估体内短期组织反应,增强型T2加权磁共振成像(MRI)显示了水肿的空间范围,PpIX-PDT后的横截面是Rutherrin-PDT的两倍,表明非特异性损伤减少,这通常与神经元损伤的二次波有关。在单次治疗后,在选定的治疗条件下,携带胶质瘤的大鼠接受Rutherrin介导的PDT比接受PpIX介导的PDT生存期显著延长。Rutherrin-PDT还显示肿瘤中CD8+T细胞浸润增加。
Rutherrin-PDT耐受性良好,为RG-2胶质瘤提供了一种安全有效的治疗方法。