Photodynamic Therapy for Malignant Brain Tumors
1Department of Neurosurgery, Tokyo Medical University.
Abstract:
Photodynamic therapy (PDT) using talaporfin sodium together with a semiconductor laser was approved in Japan in October 2003 as a less invasive therapy for early-stage lung cancer. The author believes that the principle of PDT would be applicable for controlling the invading front of malignant brain tumors and verified its efficacy through experiments using glioma cell lines and glioma xenograft models. An investigator-initiated clinical study was jointly conducted with Tokyo Women's Medical University with the support of the Japan Medical Association. Patient enrollment was started in May 2009 and a total of 27 patients were enrolled by March 2012. Of 22 patients included in efficacy analysis, 13 patients with newly diagnosed glioblastoma showed progression-free survival of 12 months, progression-free survival at the site of laser irradiation of 20 months, 1-year survival of 100%, and overall survival of 24.8 months. In addition, the safety analysis of the 27 patients showed that adverse events directly related to PDT were mild. PDT was approved in Japan for health insurance coverage as a new intraoperative therapy with the indication for malignant brain tumors in September 2013. Currently, the post-marketing investigation in the accumulated patients has been conducted, and the preparation of guidelines, holding training courses, and dissemination of information on the safe implementation of PDT using web sites and videos, have been promoted. PDT is expected to be a breakthrough for the treatment of malignant glioma as a tumor cell-selective less invasive therapy for the infiltrated functional brain area.
Insights
Photodynamic therapy (PDT) shows promise for treating malignant brain tumors, offering a less invasive approach. Clinical studies demonstrated significant progression-free and overall survival rates in glioblastoma patients, with mild side effects.
Area of Science:
- Oncology
- Neurosurgery
- Photomedicine
Background:
- Photodynamic therapy (PDT) using talaporfin sodium and semiconductor laser is approved for early-stage lung cancer in Japan.
- The potential of PDT for controlling malignant brain tumor invasion was hypothesized.
- Previous research established PDT's efficacy in preclinical glioma models.
Purpose of the Study:
- To evaluate the efficacy and safety of talaporfin sodium-based PDT as an intraoperative therapy for malignant brain tumors.
- To assess patient survival outcomes and treatment-related adverse events.
Main Methods:
- An investigator-initiated clinical study involving 27 patients with malignant brain tumors was conducted.
- Efficacy analysis included 22 patients, focusing on progression-free survival (PFS) and overall survival (OS).
- Safety analysis assessed adverse events directly related to PDT.
Main Results:
- For 13 newly diagnosed glioblastoma patients, median PFS was 12 months, PFS at the irradiation site was 20 months, 1-year survival was 100%, and median OS was 24.8 months.
- Adverse events directly related to PDT were mild in all 27 patients.
- PDT received approval for intraoperative therapy for malignant brain tumors in Japan in September 2013.
Conclusions:
- Talaporfin sodium-based PDT is a safe and effective intraoperative therapy for malignant brain tumors, particularly glioblastoma.
- PDT offers a less invasive, tumor cell-selective treatment option for infiltrated functional brain areas.
- Ongoing post-marketing investigations and educational initiatives promote the safe implementation of PDT.
