Clinical Practice of Photodynamic Therapy Using Talaporfin Sodium for Esophageal Cancer

Tomonori Yano, Tatsunori Minamide, Kenji Takashima, Keiichiro Nakajo, Tomohiro Kadota, Yusuke Yoda, Tomonori Yano, Tatsunori Minamide, Kenji Takashima, Keiichiro Nakajo, Tomohiro Kadota, Yusuke Yoda

Abstract

Photodynamic therapy (PDT) using a conventional photosensitizer was approved for esophageal cancer in the early 1990s; however, it was replaced by other conventional treatment modalities in clinical practice because of the high frequency of cutaneous phototoxicity and esophageal stricture after the procedure. The second-generation photosensitizer, talaporfin sodium, which features more rapid clearance from the body, was developed to reduce skin phototoxicity, and talaporfin sodium can be excited at longer-wavelength lights comparing with a conventional photosensitizer. Endoscopic PDT using talaporfin sodium was initially developed for the curative treatment of central-type early lung cancer in Japan, and was approved in the early 2000s. After preclinical experiments, PDT using talaporfin sodium was investigated for patients with local failure after chemoradiotherapy, which was the most serious unmet need in the practice of esophageal cancer. According to the favorable results of a multi-institutional clinical trial, PDT using talaporfin sodium was approved as an endoscopic salvage treatment for patients with local failure after chemoradiotherapy for esophageal cancer. While PDT using talaporfin sodium is gradually spreading in clinical practice, further evaluation at the point of clinical benefit is necessary to determine the importance of PDT in the treatment of esophageal cancer.

Keywords: esophageal cancer; photodynamic therapy; talaporfin sodium.

Conflict of interest statement

T.Y. received lecture fees from Meiji Seika Pharma. Other authors have no conflict of interest to be declared.

Figures

Figure 1
Figure 1
Structural formula of talaporfin sodium.
Figure 2
Figure 2
The system of a diode laser which can excite talaporfin sodium.
Figure 3
Figure 3
A clinical flowchart for the indication of PDT using talaporfin sodium for esophageal cancer.
Figure 4
Figure 4
Endoscopic images of PDT procedure for local failure lesion after chemoradiotherapy for esophageal cancer. (a) The local failure lesion; we planned to illuminate laser the for two spots (yellow circles) to cover whole the lesion (identified with green arrows). (b) An opaque hood was attached at the tip of the endoscope to shield the surrounding mucosa during the illumination in order to avoid esophageal stricture. (c) The fluence of the diode laser at 100 J/cm2 with a fluence rate of 150 mW/cm2 was delivered through endoscopy, keeping a distance of less than 2 cm from the surface of the mucosa. (d) Endoscopic image a day after PDT showing the ischemic change at the laser-illuminated mucosa (identified with blue arrows).

References

    1. Dolmans D.E., Fukumura D., Jain R.K. Photodynamic therapy for cancer. Nat. Rev. Cancer. 2003;3:380–387. doi: 10.1038/nrc1071.
    1. Wu H., Minamide T., Yano T. Role of photodynamic therapy in the treatment of esophageal cancer. Dig. Endosc. 2019;31:508–516. doi: 10.1111/den.13353.
    1. Shaheen N.J., Sharma P., Overholt B.F., Wolfsen H.C., Sampliner R.E., Wang K.K., Lightdale C.J. Radiofrequency ablation in Barrett's esophagus with dysplasia. N. Engl. J. Med. 2009;360:2277–2288. doi: 10.1056/NEJMoa0808145.
    1. Oyama T., Tomori A., Hotta K., Morita S., Kominato K., Tanaka M., Miyata Y. Endoscopic submucosal dissection of early esophageal cancer. Clin. Gastroenterol. Hepatol. 2005;3:S67–S70. doi: 10.1016/S1542-3565(05)00291-0.
    1. Aizawa K., Okunaka T., Ohtani T., Kawabe H., Yasunaka Y., O'Hata S., Saito T. Localization of mono-L-aspartyl chlorin e6 (NPe6) in mouse tissue. Photochem. Photobiol. 1987;46:789–793. doi: 10.1111/j.1751-1097.1987.tb04849.x.
    1. Nelson J.S., Roberts W.G., Berns M.W. In vivo studies on the utilization of mono-L-aspartyl chlorin (NPe6) for photodynamic therapy. Cancer Res. 1987;47:4681–4685.
    1. Wong Kee Song L.M., Wang K.K., Zinsmeister A.R. Mono-L-aspartyl chlorin e6 (NPe6) and hematoporphyrin derivative (HpD) in photodynamic therapy administered to a human cholangiocarcinoma mode. Cancer. 1998;82:421–427. doi: 10.1002/1097-0142(19980115)82:2<421::AID-CNCR25>;2-O.
    1. McMahon K.S., Wieman T.J., Moore P.H., Fingar V.H. Effects of photodynamic therapy using mono-L-aspartyl chlorin e6 on vessel constriction, vessel leakage, and tumor response. Cancer Res. 1994;54:5374–5379.
    1. Taber S.W., Fingar V.H., Coots C.T., Wieman T.J. Photodynamic therapy using mono-L-aspartyl chlorin e6 (Npe6) for the treatment of cutaneous disease: A Phase I clinical study. Clin. Cancer Res. 1998;4:2741–2746.
    1. Furukawa K., Okunaka T., Tsuchida T. A phase I clinical study of photodynamic therapy for early-stage lung carcinoma using ME2906 and a diode laser system. Porphyrins. 1998;7:199–206.
    1. Kato H., Furukawa K., Sato M., Okunaka T., Kusunoki Y., Kawahara M., Horinouchi H. Phase II clinical study of photodynamic therapy using mono-L-aspartyl chlorin e6 and diode laser for early superficial squamous cell carcinoma of the lung. Lung Cancer. 2003;42:103–111. doi: 10.1016/S0169-5002(03)00242-3.
    1. Zenda S., Hironaka S., Taku K., Sato H., Hashimoto T., Hasuike N., Nishimura T. Optimal timing of endoscopic evaluation of the primary site of esophageal cancer after chemoradiotherapy or radiotherapy: A retrospective analysis. Dig. Endosc. 2009;21:245–251. doi: 10.1111/j.1443-1661.2009.00900.x.
    1. Yano T., Muto M., Minashi K., Iwasaki J., Kojima T., Fuse N., Ohtsu A. Photodynamic therapy as salvage treatment for local failure after chemoradiotherapy in patients with esophageal squamous cell carcinoma: A phase II study. Int. J. Cancer. 2012;131:1228–1234. doi: 10.1002/ijc.27320.
    1. Hatogai K., Yano T., Kojima T., Onozawa M., Daiko H., Nomura S., Yoda Y., Doi T., Kaneko K., Ohtsu A. Salvage photodynamic therapy for local failure after chemoradiotherapy for esophageal squamous cell carcinoma. Gastrointest. Endosc. 2016;83:1130–1139. doi: 10.1016/j.gie.2015.11.016.
    1. Horimatsu T., Muto M., Yoda Y., Yano T., Ezoe Y., Miyamoto S., Chiba T. Tissue damage in the canine normal esophagus by photoactivation with talaporfin sodium (laserphyrin): A preclinical study. PLoS ONE. 2012;7:e38308. doi: 10.1371/journal.pone.0038308.
    1. Yano T., Muto M., Yoshimura K., Niimi M., Ezoe Y., Yoda Y., Yamamoto Y., Nishisaki H., Higashino K., Iishi H. Phase I study of photodynamic therapy using talaporfin sodium and diode laser for local failure after chemoradiotherapy for esophageal cancer. Radiat. Oncol. 2012;7:113. doi: 10.1186/1748-717X-7-113.
    1. Yano T., Kasai T., Horimatsu K., Yoshimura S., Teramukai S., Morita H., Tada Y., Yamamoto H., Kataoka N., Kakushima R., et al. Isomoto and M. Muto A multicenter phase II study of salvage photodynamic therapy using talaporfin sodium (ME2906) and a diode laser (PNL6405EPG) for local failure after chemoradiotherapy or radiotherapy for esophageal cancer. Oncotarget. 2017;8:22135–22144. doi: 10.18632/oncotarget.14029.
    1. Yano T., Muto M., Hattori S., Minashi K., Onozawa M., Nihei K., Ishikura S., Ohtsu A., Yoshida S. Long-term results of salvage endoscopic mucosal resection in patients with local failure after definitive chemoradiotherapy for esophageal squamous cell carcinoma. Endoscopy. 2008;40:717–721. doi: 10.1055/s-2008-1077480.
    1. Nakajo K., Yoda Y., Hori K., Takashima K., Sinmura K., Oono Y., Ikematsu H., Yano T. Technical feasibility of endoscopic submucosal dissection for local failure after chemoradiotherapy or radiotherapy for esophageal squamous cell carcinoma. Gastrointest. Endosc. 2018;88:637–646. doi: 10.1016/j.gie.2018.06.033.
    1. Mitchell K.G., Nelson D.B., Corsini E.M., Vaporciyan A.A., Antonoff M.B., Mehran R.J., Rice D.C., Roth J.A., Sepesi B., Walsh G.L., et al. Morbidity following salvage esophagectomy for squamous cell carcinoma: The MD Anderson experience. Dis. Esophagus. 2020;33:doz067. doi: 10.1093/dote/doz067.
    1. Cohen C., Tessier W., Gronnier C., Renaud F., Pasquer A., Théreaux J., Gagnière J., Meunier B., Collet D., Piessen G., et al. FREGAT (French Eso-Gastric Tumors working group)—FRENCH (Fédération de Recherche en Chirurgie)—AFC (Association Française de Chirurgie). Salvage Surgery for Esophageal Cancer: How to Improve Outcomes? Ann. Surg. Oncol. 2018;25:1277–1286. doi: 10.1245/s10434-018-6365-1.
    1. Mitchell K.G., Nelson D.B., Corsini E., Vaporciyan A.A., Antonoff M.B., Mehran R.J., Rice D.C., Roth J.A., Sepesi B., Walsh G.L., et al. Predictors of stricture formation after photodynamic therapy for high-grade dysplasia in Barrett’s esophagus. Gastrointest. Endosc. 2007;65:60–66.
    1. Yano T., Muto M., Minashi K., Onozawa M., Nihei K., Ishikura S., Kaneko K., Ohtsu A. Long-term results of salvage photodynamic therapy for patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma. Endoscopy. 2011;43:657–663. doi: 10.1055/s-0030-1256373.
    1. Ishida N., Osawa S., Miyazu T., Kaneko M., Tamura S., Tani S., Yamade M., Iwaizumi M., Hamaya Y., Furuta T., et al. Photodynamic therapy Using Talaporfin Sodium for Local Failure after Chemoradiotherapy or Radiotherapy for Esophageal Cancer: A Single Center Experience. J. Clin. Med. 2020;9:1509. doi: 10.3390/jcm9051509.
    1. Hayashi T., Asahina Y., Nakanishi H., Terashima T., Okamoto K., Yamada S., Takatori H., Kitamura K., Mizukoshi E., Ninomiya I., et al. Evaluation of the efficacy and safety of salvage photodynamic therapy by talaporfin sodium for cervical esophageal cancers and lesions larger than 3 cm. Esophagus. 2020 doi: 10.1007/s10388-020-00799-6.
    1. Minamide T., Yoda Y., Hori K., Shinmura K., Oono Y., Ikematsu H., Yano T. Advantages of salvage photodynamic therapy using talaporfin sodium for local failure after chemoradiotherapy or radiotherapy for esophageal cancer. Surg. Endosc. 2020;34:899–906. doi: 10.1007/s00464-019-06846-3.
    1. Amanuma Y., Horimatsu T., Ohashi S., Tamaoki M., Muto M. Association of local complete response with prognosis after salvage photodynamic therapy for esophageal squamous cell carcinoma. Dig. Endosc. 2021;33:355–363. doi: 10.1111/den.13730.
    1. Castano A.P., Mroz P., Hamblin M.R. Photodynamic therapy and anti-tumour immunity. Nat. Rev. Cancer. 2006;6:535–545. doi: 10.1038/nrc1894.
    1. Minamide T., Yoda Y., Hori K., Shinmura K., Oono Y., Ikematsu H., Yano T. Potential of Photodynamic Therapy Based on Sugar-Conjugated Photosensitizers. J. Clin. Med. 2021;10:841. doi: 10.3390/jcm10040841.
    1. Kato K., Cho B.C., Takahashi M., Okada M., Lin C.Y., Chin K., Kitagawa Y. Nivolumab versus chemotherapy in patients with advanced oesophageal squamous cell carcinoma refractory or intolerant to previous chemotherapy (ATTRACTION-3): A multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2019;20:1506–1517. doi: 10.1016/S1470-2045(19)30626-6.
    1. Kojima T., Shah M.A., Muro K., Francois E., Adenis A., Hsu C. HRandomized Phase III KEYNOTE-181 Study of Pembrolizumab Versus Chemotherapy in Advanced Esophageal Cancer. J. Clin. Oncol. 2020;38:4138–4148. doi: 10.1200/JCO.20.01888.
    1. Cramer G.M., Moon E.K., Cengel K.A., Busch T.M. Photodynamic Therapy and Immune Checkpoint Blockade. Photochem. Photobiol. 2020;96:954–961. doi: 10.1111/php.13300.
    1. Yano T., Wang K.K. Photodynamic Therapy for Gastrointestinal Cancer. Photochem. Photobiol. 2020;96:517–523. doi: 10.1111/php.13206.
    1. Nanashima A., Abo T., Nonaka T., Nonaka Y., Morisaki T., Uehara R., Nagayasu T. Photodynamic therapy using talaporfin sodium (Laserphyrin®) for bile duct carcinoma: A preliminary clinical trial. Anticancer Res. 2012;32:4931–4938. doi: 10.1016/j.jamcollsurg.2015.08.169.
    1. Nakamura T., Oinuma T. Usefulness of Photodynamic Diagnosis and Therapy using Talaporfin Sodium for an Advanced-aged Patient with Inoperable Gastric Cancer. Laser Ther. 2014;23:201–210. doi: 10.5978/islsm.14-OR-16.

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