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3 juni 2018: deze studie: Melanoma: Surgery Subsequent to PDT—Is It Worth Doing? A 10-Year Pilot Trial Using Chlorin-Type Photosensitizer Bremachlorin®

laat zien dat wanneer de fotosensitizer bremachlorin (vroeger radachlorin  geheten) gebruikt wordt 1 dag vantevoren en tijdens de operatie bij de PDT - Foto Dynamische Therapie naast de operatie van een kwaadaardige moedervlek - melanoom de kansen op een recidief sterk vermindert en de overall overleving sterk verbetert. In deze kleinschalige gerandomiseerde studie bij totaal 49 patiënten (24 vs 25) bleek op 5 jaar iedereen uit de chirurgie + PDT groep nog te leven versus slechts 9 uit 24 patienten uit de groep die alleen chirurgie kregen. De PDT met bremachlorin blijkt dus uitstekend te werken met ook minder bijwerkingen en littekens.

Zie ook de patientenverhalen van Karen (borstkanker) en meneer A (prostaatkanker) die begin jaren 2000 naar Ierland (dr. Carmody) en Duitsland (Hufeland kliniek) gingen voor hun kanker te behandelen met PDT met radachlorin.

Uit het abstract: 

(a)(b)

Figure 1. (a) Melanoma of the skin before PDT with photosensitizer Bremachlorin in a combination with surgery. (b) Melanoma after removal: the depth of 662-nm-laser light penetration and corresponding infiltrate are well seen to be around 6 mm.

(a)(b)

Figure 2. (a) A 80-year-old patient having melanoma of the skin with a 30-year backgroung of Dubreuilh’s melanosis. (b) In 1 year after PDT combined with surgical resection and a plastic operation. Five year cancer free follow-up.

(a)(b)

Figure 3. (a) Before PDT. (b) In 1 year after PDT combined with surgical resection and a plastic operation.

Hexvix, Photofrin II) PDT owing to better pharmaceutical, spectral, pharmacokinetic, toxicological, and energy performance of the former.

By the present study we have shown that combining surgery with PDT performed prior to resection the efficiency of the former may go up more than twice. The obligatory condition for such a rise in the effect seems to be using the 2nd and 3rd generation PSs with effective depth of necrosis exceeding 3 mm, invasion level not more than 3, and absence of local and distant metastases.

Het volledige studierapport: 

Het volledige studierapport is in te zien op  http://file.scirp.org/Html/5-8902602_80067.htm#txtF3

We hebben het officiele studiedrapport ook beschikbaar voor onze donateurs.

Hier het abstract plus referentielijst:

Melanoma: Surgery Subsequent to PDT—Is It Worth Doing? A 10-Year Pilot Trial Using Chlorin-Type Photosensitizer Bremachlorin®

Full-Text HTML XML Download Download as PDF (Size:1192KB) PP. 902-912
DOI: 10.4236/jct.2017.810079    129 Downloads   252 Views  
Author(s)    Leave a comment
Evgeniy I. Volkov1, Andrei V. Reshetnickov2,3*, Harrie Vink3

ABSTRACT

Bremachlorin®, also known as “Radachlorin®” and Photochlorin, a composition of 3 chlorophyll a derivatives in an aqueous solution [1], was initially introduced into the Russian and South Korean Pharmacopoeias with the corresponding marketing authorizations received in 2006 and 2008, on the basal cell skin carcinoma PDT protocol. Phase I-II clinical trials led in 2002-2005 showed no side effects, a good tolerability by patients and a high clinical anti-tumor efficacy. Further studies described in the present paper were fulfilled in accordance with a skin melanoma PDT + surgery combined technique protocol in 2006-2016. Resulting from the present trial, up to the 100% complete responses were achieved after resection and plastic surgery following PDT, with no melanoma regrowth or metastases during 5 and 10-year observation periods. Conducting PDT one day prior to tumor dissection can guarantee to meet the ablastics principles at the subsequent surgery. At the same time, the PDT + surgery protocol can allow for dissecting the tumor with less distance from its edge, which seems to be important for the face localizations of tumors.

References

[1] Reshetnickov, A.V., et al. (2001) Photosensitizer, and Method Therefore. Patents of South Africa-2003/8407, Australia-2002212867, New Zealand-528237, United Kingdom-GB2389531, Norway-327751, Sweden-01981209.8, Italy-70446-BE/2009, Slovenia, The Netherlands, Rep. of Ireland, France, Germany, Switzerland, Belgium-1380295. Assignee: RADA-PHARMA International B.V., The Netherlands, Priority of 04.10.2001.
[2] Cohen, D.K. and Lee, P.K. (2016) Photodynamic Therapy for Non-Melanoma Skin Cancers. Cancers, 8, 90.
https://doi.org/10.3390/cancers8100090
[3] Voet, M.A. (2004) Photodynamic Therapy for Pre-Melanomas. US Pat.6,723,750. Assignee: Allergan Inc., Irvine, CA, Priority of 20.04.2004.
[4] Kochneva, E.V., Filonenko, E.V., Vakulovskaya, E.G., Scherbakova, E.G., Seliverstov, O.V., Markichev, N.A. and Reshetnickov, A.V. (2010) Photosensitizer Radachlorin®: Skin Cancer PDT Phase II Clinical Trials. Photodiagnosis and Photodynamic Therapy, 7, 258-267.
https://doi.org/10.1016/j.pdpdt.2010.07.006
[5] Reshetnickov, A.V. and Mead, M.N. (2013) The Medicine of Light. The 1st Edition, Amazon Press, USA, 255 p. (2014) The 2nd Edition, Pumbo, The Netherlands, 271 p. © by Photoimmune Discoveries B.V.
http://www.photoimmune.org/
[6] Douillard, S, Olivier, D, Patrice, T. (2009) In Vitro and In Vivo Evaluation of Radachlorin Sensitizer for Photodynamic Therapy. Photochemical & Photobiological Sciences, 8, 405-413.
https://doi.org/10.1039/b817175k
[7] Markichev, N.A., Eliseyenko, V.I., Alexeyev, Y.V., Armichev, A.V. and Reshetnickov, A.V. (2004) Photodynamic Therapy of Cutaneous Basal-Cell Carcinoma Using Photosensitizer from the Chlorins Family Radachlorin. Laser Medicine, 8, 144-145. (in Russian)
[8] Peris, K., Tambone, S., Kostaki, D., Varrassi, E. and Fargnoli, M.C. (2014) Treatments of Advanced Basal Cell Carcinoma: A Review of the Literature. Giornale Italiano Di Dermatologia E Venereologia, 151, 77-86.
[9] Ahn, J.C., Biswas, R., Mondal, A., Lee, Y.K. and Chung, P.S. (2013) Cisplatin Enhances the Efficacy of 5-Aminolevulinic Acid Mediated Photodynamic Therapy in Human Head and Neck Squamous Cell Carcinoma. General Physiology and Biophysics, 33, 53-62.
https://doi.org/10.4149/gpb_2013046
[10] Paches, A.I. (2000) Head and Neck Tumors. Moscow, Russia (in Russian).
[11] Demidov, L.V., Kharkevich, G.Yu. (2003) Skin Melanoma: Staging, Diagnostics and Treatment. The Russian Medical Journal, 11, 41-43. (in Russian).
[12] Bulat, Yu.V. (2001) The Contemporary Solutions to the Chemotherapy of the Disseminated Skin Melanoma. Moscow, Russia. (in Russian).
[13] Fyodorov, S.N., Kopaeva, V.G., et al. (1996) Vascular Effects of PDT. CIS Selected Papers: Laser Use in Oncology, SPIE, Proceedings Vol. 2728.


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