Photodynamic therapy with intravesical instillation of 5-aminolevulinic acid for patients with recurrent superficial bladder cancer: a single-center study

Berger, Andreas; Steiner, H; Stenzl, Arnulf; Akkad, Thomas; Bartsch, Georg; Höltl, Lorenz

doi:10.1016/s0090-4295(02)02123-4

Cited by 133 publications

(80 citation statements)

References 15 publications

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“…Fluorescence-guided surgery may better allow the surgeon to spare normal tissue and achieve clear tumor margins. This has already been demonstrated to be feasible for cutaneous tumors and bladder cancer [64,65]. Current PSs may also be employed as a one-two punch against tumors, using both surgery to remove gross disease and PDT to eliminate microscopic extensions.…”

Section: Imagingmentioning

confidence: 99%

Future of Oncologic Photodynamic Therapy

Bagnato²,

2010

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Photodynamic therapy (PDT) is a tumor-ablative and function-sparing oncologic intervention. The relative simplicity of photosensitizer application followed by light activation resulting in the cytotoxic and vasculartoxic photodynamic reaction has allowed PDT to reach a worldwide audience. With several commercially available photosensitizing agents now on the market, numerous well designed clinical trials have demonstrated the efficacy of PDT on various cutaneous and deep tissue tumors. However, current photosensitizers and light sources still have a number of limitations. Future PDT will build on those findings to allow development and refinement of more optimal therapeutic agents and illumination devices. This article reviews the current state of the art and limitations of PDT, and highlight the progress being made towards the future of oncologic PDT.

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Section: Imagingmentioning

confidence: 99%

Future of Oncologic Photodynamic Therapy

Bagnato²,

2010

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“…Several early studies suggested a benefit and one small study in 34 patients reported a favourable diseasefree recurrence rate. [110][111][112] However, despite the novelty in these and other approaches, none have been evaluated in a definitive, practicechanging study or are currently considered standard therapy.…”

Section: Novel Agentsmentioning

confidence: 99%

Consensus statement on best practice management regarding the use of intravesical immunotherapy with BCG for bladder cancer

et al. 2015

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| Multiple clinical trials have demonstrated that intravesical Bacillus Calmette-Guérin (BCG) treatment reduces recurrences and progression in patients with non-muscle-invasive bladder cancer (NMIBC). However, although BCG has been in use for almost 40 years, this agent is often underutilized and practice patterns of administration vary. This neglect is most likely caused by uncertainties about the optimal use of BCG, including unawareness of optimal treatment schedules and about patient populations that most benefit from BCG treatment. To address this deficit, a focus group of specialized urologic oncologists (urologists, medical oncologists and radiation oncologists) reviewed the current guidelines and clinical evidence, discussed their experiences and formed a consensus regarding the optimal use of BCG in the management of patients with NIMBC. The experts concluded that continuing therapy with 3-week BCG maintenance is superior to induction treatment only and is the single most important factor in improving outcomes in patients with NMIBC. They also concluded that a reliable alternative to radical cystectomy in truly BCG-refractory disease remains the subject of clinical trials. In addition, definitions for common terms of BCG failure, such as BCG-refractory and BCG-intolerant, have been formulated.

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“…Hypericin and ALA-induced PpIX do not only exhibit red fluorescence upon blue light irradiation, both compounds are also potent photosensitizers and hence could be useful in the photodynamic therapy (PDT) of NMIBC after intrabladder instillation [21][22][23]. PDT for cancer involves the local or systemic administration of a photosensitizer followed by local irradiation of 4 the tumor tissue with non-thermal visible light of a specific wavelength.…”

Section: Introductionmentioning

confidence: 99%

Biodistribution of PVP-hypericin and hexaminolevulinate-induced PpIX in normal and orthotopic tumor-bearing rat urinary bladder

Vandepitte

Cleynenbreugel

Hettinger

et al. 2010

Cancer Chemother Pharmacol

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PurposeIn this preclinical study we examined the biodistribution of hypericin formulated as its watersoluble PVP-hypericin complex in the different layers (urothelium, submucosa, muscle) of a normal rat bladder and a rat bladder bearing a malignant urothelium composed of syngeneic AY-27 tumor cells. The results were compared with the biodistribution of hexaminolevulinate (HAL) induced protoporphyrin IX (PpIX). MethodsFreshly prepared PVP-hypericin and HAL solutions were instilled in both normal as well as tumor bearing rat bladders. Following instillation, bladders were removed and snap frozen in liquid nitrogen. Fluorescence of PVP-hypericin or PpIX induced HAL was measured in the bladder layers and quantified using image analysis software. ResultsThe results of these experiments show that PVP-hypericin (30 µM) accumulated about 3.5-fold more in malignant urothelial tissue as compared to normal urothelium, whereas PpIX accumulated to the same extent in malignant and normal urothelium, both after intra-bladder instillation of 8 or 16 mM HAL. Besides, PVP-hypericin and PpIX accumulated selectively in the urothelium with a tumor-to-muscle ratio of 30.6 for PVP-hypericin and 3.7 to 8.3 for 16 and 8 mM HAL, respectively. ConclusionsThis study shows that PVP-hypericin appears to have great potential as a photodynamic agent against non-muscle invasive bladder cancers after intravesical administration, with a limited risk of affecting the deeper layers of the bladder.

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Photodynamic therapy with intravesical instillation of 5-aminolevulinic acid for patients with recurrent superficial bladder cancer: a single-center study

Cited by 133 publications

References 15 publications

Future of Oncologic Photodynamic Therapy

Future of Oncologic Photodynamic Therapy

Consensus statement on best practice management regarding the use of intravesical immunotherapy with BCG for bladder cancer

Biodistribution of PVP-hypericin and hexaminolevulinate-induced PpIX in normal and orthotopic tumor-bearing rat urinary bladder

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