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.
Highlights
Photodynamic therapy (PDT) is a unique cancer treatment that involves a photosensitizer (PS), which is incorporated into cancer cells and activates light of a specific wavelength
In the United States, PDT has been approved as a palliative treatment for symptomatic obstructive advanced esophageal cancer, and eradicative ablation of high-grade dysplasia of the esophagus, which is a premalignant disease of esophageal adenocarcinoma
We review the history of PDT using talaporfin sodium, a second-generation photosensitizer, and its progression into clinical practice for use in esophageal cancer cases
Summary
Photodynamic therapy (PDT) is a unique cancer treatment that involves a photosensitizer (PS), which is incorporated into cancer cells and activates light of a specific wavelength. Esophageal cancer was, in the early 1990s, one of the first approved clinical indications of PDT using conventional porphyrin-based PS both in the United States and Japan [2]. In the United States, PDT has been approved as a palliative treatment for symptomatic obstructive advanced esophageal cancer, and eradicative ablation of high-grade dysplasia of the esophagus, which is a premalignant disease of esophageal adenocarcinoma. PDT was approved as a curative treatment for superficial esophageal cancer that was deemed difficult to remove with conventional endoscopic resection (ER) in Japan. PDT was replaced in clinical practice by other effective and conventional treatment modalities for esophageal cancer patients in both countries at the beginning of the 2000s. We review the history of PDT using talaporfin sodium, a second-generation photosensitizer, and its progression into clinical practice for use in esophageal cancer cases
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