The Rationale for “Laser-Induced Thermal Therapy (LITT) and Intratumoral Cisplatin” Approach for Cancer Treatment

Abstract

Cisplatin is one of the most widely used anticancer drugs in the treatment of various types of solid human cancers, as well as germ cell tumors, sarcomas, and lymphomas. Strong evidence from research has demonstrated higher efficacy of a combination of cisplatin and derivatives, together with hyperthermia and light, in overcoming drug resistance and improving tumoricidal efficacy. It is well known that the antioncogenic potential of CDDP is markedly enhanced by hyperthermia compared to drug treatment alone. However, more recently, accelerators of high energy particles, such as synchrotrons, have been used to produce powerful and monochromatizable radiation to induce an Auger electron cascade in cis-platinum molecules. This is the concept that makes photoactivation of cis-platinum theoretically possible. Both heat and light increase cisplatin anticancer activity via multiple mechanisms, generating DNA lesions by interacting with purine bases in DNA followed by activation of several signal transduction pathways which finally lead to apoptosis. For the past twenty-seven years, our group has developed infrared photo-thermal activation of cisplatin for cancer treatment from bench to bedside. The future development of photoactivatable prodrugs of platinum-based agents injected intratumorally will increase selectivity, lower toxicity and increase efficacy of this important class of antitumor drugs, particularly when treating tumors accessible to laser-based fiber-optic devices, as in head and neck cancer. In this article, the mechanistic rationale of combined intratumor injections of cisplatin and laser-induced thermal therapy (CDDP–LITT) and the clinical application of such minimally invasive treatment for cancer are reviewed.

Current status and research progress of minimally invasive treatment of glioma

“…The basic principles involved including the conversion of light laser energy into photothermal energy (heat) by the absorption of photons by the tissue, as well as thermal diffusion, distributing this photothermal energy progressively at lower levels towards the tissue margins, acting under three mechanisms, as shown in Figure 4 : laser-induced coagulation (LIC: > 60°C), dynamic thermal reaction (TDR: 48–60°C) and laser-induced hyperthermia (LIHT: 42–47 °C). In the core of the irradiated area, there is virtually instantaneous irreversible cell destruction at temperatures > 60 °C,while the tissue margins may suffer reversible cell damage (42–60°C), and, in the case of tumors, it becomes a region with a high rate of relapses, acting better in conjunction with chemotherapy ( 23 , 24 ).…”

Gold Nanorods with Mesoporous Silica Shell: A Promising Platform for Cisplatin Delivery

“…It has been demonstrated that hyperthermia potentiates the effect of cisplatin on tumor treatment by increasing cellular drug uptake and stimulating apoptosis [ 15 , 16 ]. It is well-known that gold nanoparticles (AuNP) can induce local hyperthermy by laser irradiation through a phenomenon known as surface plasmon resonance (SPR), which arises from coherent electron oscillation trough gold nanostructures’ surface [ 17 , 18 ].…”