Advantages of salvage photodynamic therapy using talaporfin sodium for local failure after chemoradiotherapy or radiotherapy for esophageal cancer

2019 ◽  
Vol 34 (2) ◽  
pp. 899-906 ◽  
Author(s):  
Tatsunori Minamide ◽  
Yusuke Yoda ◽  
Keisuke Hori ◽  
Kensuke Shinmura ◽  
Yasuhiro Oono ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Photodynamic Therapy ◽  
Local Failure ◽  
Talaporfin Sodium

PS02.038: SAFETY AND EFFICACY OF REPETITIVE PHOTODYNAMIC THERAPY FOR RESIDUAL ESOPHAGEAL CANCER LESIONS AFTER INITIAL PHOTODYNAMIC THERAPY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 130-131
Author(s):  
Masashi Tamaoki ◽  
Yusuke Amanuma ◽  
Takahiro Horimatsu ◽  
Shinya Ohashi ◽  
Manabu Muto
Keyword(s):  
Esophageal Cancer ◽  
Photodynamic Therapy ◽  
Conflicts Of Interest ◽  
Complete Response ◽  
Best Supportive Care ◽  
Local Failure ◽  
University Hospital ◽  
Safety And Efficacy ◽  
Lesion Depth ◽  
Talaporfin Sodium

Abstract Background Photodynamic therapy (PDT) is an effective salvage treatment for local failure after chemoradiotherapy in patients with esophageal cancers. However, the treatment strategy for local failure after initial PDT has not been established, and the safety and efficacy of repetitive PDT for such lesions are also unknown. Methods We retrospectively investigated 33 esophageal cancer patients who received initial salvage PDT at Kyoto University Hospital between May 2012 and November 2017. Additionally, we examined the treatment outcomes of those patients who received repetitive PDT. Results Twenty-one patients (64%) achieved local complete response (CR) by initial PDT, and local recurrence did not occur in those patients. Eleven patients (33%) had residual lesions after initial PDT. Among these, 7 patients were treated with repetitive PDT, 2 patients selected best supportive care, 1 patient was treated with surgery, and 1 patient was treated with chemotherapy. Five of the 7 patients who received repetitive PDT were treated with talaporfin sodium, and 2 patients were treated with porfimer sodium. The median age of the patients who received repetitive PDT was 70 years old, and all patients were men. Regarding histology, 6 patients were squamous cell carcinoma and 1 patient was adenocarcinoma. The median period from initial PDT to repetitive PDT was 3 months (range 1–4). Lesion depth before initial PDT was T1 in 3 patients and T2 in 4 patients. Lesion depth before repetitive PDT was T1 in 5 patients, and T2 in 2 patients. Local CR rate in 7 patients treated with repetitive PDT was 42.9% (3/7). Additionally, local CR rate in T1 cases was 60% and 0% in T2 cases. Adverse events of grade 3 or higher were not observed in any patient. Conclusion Repetitive salvage PDT was considered to be an effective and safe treatment option in residual T1 lesions after initial PDT for local failure of esophageal cancer treated with chemoradiotherapy. Disclosure All authors have declared no conflicts of interest.

scholarly journals Phase I study of photodynamic therapy using talaporfin sodium and diode laser for local failure after chemoradiotherapy for esophageal cancer

2012 ◽  
Vol 7 (1) ◽  
pp. 113 ◽  
Author(s):  
Tomonori Yano ◽  
Manabu Muto ◽  
Kenichi Yoshimura ◽  
Miyuki Niimi ◽  
Yasumasa Ezoe ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Photodynamic Therapy ◽  
Phase I ◽  
Diode Laser ◽  
Phase I Study ◽  
Local Failure ◽  
Talaporfin Sodium

scholarly journals Repeated talaporfin sodium photodynamic therapy for esophageal cancer: safety and efficacy

Esophagus ◽  
2021 ◽  
Author(s):  
Masashi Tamaoki ◽  
Akira Yokoyama ◽  
Takahiro Horimatsu ◽  
Kenshiro Hirohashi ◽  
Yusuke Amanuma ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Photodynamic Therapy ◽  
Local Recurrence ◽  
Residual Tumor ◽  
Complete Response ◽  
Esophageal Stenosis ◽  
Local Failure ◽  
University Hospital ◽  
Safety And Efficacy ◽  
Talaporfin Sodium

Abstract Background Talaporfin sodium photodynamic therapy (tPDT) is an effective salvage treatment for local failure after chemoradiotherapy for esophageal cancer. Repeated tPDT could also be indicated for local recurrence or residue after the first salvage tPDT. However, the safety and efficacy of repeated tPDT have not been elucidated. Methods We reviewed 52 patients with esophageal cancer who were treated with the first tPDT at Kyoto University Hospital between October 2015 and April 2020. Results Among 52 patients, repeated tPDT after the first tPDT was indicated for 13 patients (25%), of which six had residual tumor, four had local recurrence after complete response (CR) after the first tPDT at the primary site, and six had metachronous lesion. The total session of repeated tPDT was 25; 16 were for primary sites and nine were for metachronous sites. Among them, six patients (46.2%) achieved local (L)-CR and nine lesions (56.3%) achieved lesion L-CR. By session, 10 sessions (40%) achieved L-CR. There were no severe adverse events except for one patient; this patient showed grade 3 esophageal stenosis and perforation after the third tPDT on the same lesion that was previously treated with porfimer sodium photodynamic therapy four times. Conclusion Repeated tPDT could be an effective and safe treatment for local failure even after salvage tPDT for esophageal cancer.

PS02.034: EFFICACY AND SAFETY OF SALVAGE PHOTODYNAMIC THERAPY USING TALAPORFIN SODIUM FOR LOCAL FAILURE AFTER CHEMORADIOTHERAPY IN PATIENTS WITH ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 129-129
Author(s):  
Yusuke Amanuma ◽  
Shinya Ohashi ◽  
Masashi Tamaoki ◽  
Takahiro Horimatsu ◽  
Manabu Muto
Keyword(s):  
Esophageal Cancer ◽  
Photodynamic Therapy ◽  
Laser Irradiation ◽  
Conflicts Of Interest ◽  
Balloon Dilation ◽  
Local Failure ◽  
Laser Exposure ◽  
Efficacy And Safety ◽  
Talaporfin Sodium ◽  
Failure Patterns

Abstract Background We previously conducted an investigator-initiated trial of photodynamic therapy (PDT) using talaporfin sodium (talaporfin-PDT) and laser irradiation (PD-laser) against local failure after chemoradiotherapy (CRT) in patients with esophageal cancer (EC) and reported a high local complete response rate (L-CR) (88.5%) (Yano et al., Oncotarget 2017). Thereafter, talaporfin-PDT has been applied clinically as a salvage treatment for local failure after CRT in Japan since October 2015. The current study retrospectively reviewed the efficacy and safety of talaporfin-PDT in patients who underwent this treatment in our clinical practice. Methods This study was a single-center retrospective observational study. Patients who received salvage talaporfin-PDT for local failure of EC limited to T1–2 after definitive CRT or radiotherapy from May 2011 to July 2017 in our hospital were included. PDT was applied with an intravenous administration of talaporfin sodium (40 mg/kg) followed 4 h later by diode laser irradiation at 100 J/cm2. The primary and secondary endpoints were the rate of L-CR and the safety of PDT, respectively. The criteria for L-CR were as follows: 1) no residual tumor, 2) disappearance of post-PDT ulcer and scar formation, and 3) disappearance of cancer cells as assessed histologically. Results Thirty-one patients were analyzed in this study (26 men, 5 women, median age: 68 years). Histological types were squamous cell carcinoma and adenocarcinoma (30 and 1 patients, respectively). The failure patterns of lesions after CRT were recurrence after achieving a CR and residual lesion just after CRT (25 and 6 patients, respectively). The recurrent T stages were T1a, T1b, and T2 (1, 18, and 12 patients, respectively). The median total laser exposure dose was 500 J (range: 200–900). The L-CR rates were 84.2% (16/19), 41.7% (5/12), and 61.3% (19/31) in patients with T1, T2, and all stages, respectively. No severe adverse events greater than grade 3 related to PDT were observed. Although four patients had grade 2 esophageal stenosis after PDT, the stenosis was controlled by endoscopic balloon dilation. Conclusion Salvage talaporfin-PDT is a safe and curative treatment for local failure, especially stage T1, after CRT in patients with EC. Disclosure All authors have declared no conflicts of interest.

scholarly journals Clinical Practice of Photodynamic Therapy Using Talaporfin Sodium for Esophageal Cancer

2021 ◽  
Vol 10 (13) ◽  
pp. 2785
Author(s):  
Tomonori Yano ◽  
Tatsunori Minamide ◽  
Kenji Takashima ◽  
Keiichiro Nakajo ◽  
Tomohiro Kadota ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Photodynamic Therapy ◽  
Clinical Practice ◽  
Unmet Need ◽  
The Body ◽  
Local Failure ◽  
Treatment Modalities ◽  
Central Type ◽  
Talaporfin Sodium ◽  
Rapid Clearance

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.

scholarly journals Photodynamic Therapy Using Talaporfin Sodium for Local Failure after Chemoradiotherapy or Radiotherapy for Esophageal Cancer: A Single Center Experience

2020 ◽  
Vol 9 (5) ◽  
pp. 1509
Author(s):  
Natsuki Ishida ◽  
Satoshi Osawa ◽  
Takahiro Miyazu ◽  
Masanao Kaneko ◽  
Satoshi Tamura ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Photodynamic Therapy ◽  
Esophageal Stricture ◽  
Balloon Dilation ◽  
Complete Response ◽  
Local Failure ◽  
Talaporfin Sodium ◽  
Single Center Experience ◽  
Endoscopic Balloon

A phase II study of second-generation photodynamic therapy (PDT) using talaporfin sodium has shown excellent treatment results for esophageal cancer with local failure after chemoradiotherapy (CRT) or radiotherapy (RT). However, only a few studies have reported this therapy in clinical practice. This study aimed to confirm the efficacy and safety of salvage PDT using talaporfin sodium for esophageal cancer in various clinical situations. Twelve patients with esophageal cancer with local failure after definitive CRT or RT who underwent PDT using talaporfin sodium were enrolled from April 2016 to January 2020. Overall, 10 patients (83.3%) achieved a local complete response. No skin phototoxicity was observed, but esophageal stricture occurred in five patients (41.7%). Esophageal stricture was improved with endoscopic balloon dilation in all patients, and subsequent analysis found no significant factors causing esophageal stricture after PDT. Two patients with synchronous tumors were successfully rescued by combination therapy with endoscopic submucosal dissection. Two patients with carcinoma in situ of larger than 1/2 circumference were rescued by repeated PDT. The 2-year overall survival was 80.0% (95% confidence interval 0.409–0.946). PDT using talaporfin sodium was an effective and safe salvage treatment for esophageal cancer with local failure after CRT or RT in various clinical situations.

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