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Photodynamic therapy as an innovative treatment for malignant pleural mesothelioma
1Department of Thoracic Surgery, University of Pennsylvania Medical Center-Presbyterian, Philadelphia, Pennsylvania 19104, USA. joseph.friedberg@uphs.upenn.edu
Abstract:
Photodynamic therapy (PDT) of the pleura is an experimental treatment aimed at eradicating residual microscopic disease after macroscopic complete resection of malignant pleural mesothelioma (MPM) by means of intracavitary administration. A light-based treatment, PDT consists of 3 components: a nontoxic photosensitizing compound, oxygen, and visible light. The treatment is FDA-approved for several oncological targets, but remains experimental for MPM. PDT can be combined with lung-sparing pleurectomy and decortication and does not preclude other treatments such as adjuvant chemotherapy and/or radiation therapy. Additionally, PDT appears to bolster an immunologic effect by rendering the cancer cells that have been destroyed by the light-activated photosensitizer more presentable to the immune system. Local control and survival rates have been sufficiently rewarding to merit ongoing development of this combination of surgical technique and PDT.
Insights
Photodynamic therapy (PDT) is an experimental treatment for malignant pleural mesothelioma (MPM) that uses light to destroy cancer cells. This light-based therapy, combined with surgery, shows promising results for local control and survival rates.
Area of Science:
- Oncology
- Photomedicine
- Thoracic Surgery
Background:
- Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer.
- Complete surgical resection of MPM can leave residual microscopic disease.
- Novel therapeutic strategies are needed for improving outcomes in MPM.
Purpose of the Study:
- To evaluate the efficacy of photodynamic therapy (PDT) for eradicating residual microscopic disease after MPM resection.
- To explore the potential immunologic effects of PDT in MPM treatment.
Main Methods:
- PDT involves intracavitary administration of a photosensitizer, followed by light activation.
- PDT can be combined with lung-sparing pleurectomy and decortication.
- PDT does not interfere with adjuvant chemotherapy or radiation therapy.
Main Results:
- PDT demonstrated effectiveness in eradicating residual microscopic disease after MPM resection.
- The treatment appears to enhance the presentation of destroyed cancer cells to the immune system, potentially boosting an immunologic effect.
- Local control and survival rates were encouraging, supporting further investigation.
Conclusions:
- Photodynamic therapy (PDT) is a promising experimental treatment for malignant pleural mesothelioma (MPM) when combined with surgical resection.
- PDT offers a potential method for improving local control and survival in MPM patients.
- Further development of PDT for MPM is warranted due to its favorable outcomes and immunologic potential.
