Abstract
Photodynamic therapy (PDT), in which a light source is used in combination with a photosensitizer to induce local cell death, has shown great promise in therapeutically targeting primary tumors with negligible toxicity and minimal invasiveness. However, numerous studies have shown that noninvasive PDT alone is not sufficient to completely ablate tumors in deep tissues, due to its inherent shortcomings. Therefore, depending on the characteristics and type of tumor, PDT can be combined with surgery, radiotherapy, immunomodulators, chemotherapy, and/or targeted therapy, preferably in a patient-tailored manner. Nanoparticles are attractive delivery vehicles that can overcome the shortcomings of traditional photosensitizers, as well as enable the codelivery of multiple therapeutic drugs in a spatiotemporally controlled manner. Nanotechnology-based combination strategies have provided inspiration to improve the anticancer effects of PDT. Here, we briefly introduce the mechanism of PDT and summarize the photosensitizers that have been tested preclinically for various cancer types and clinically approved for cancer treatment. Moreover, we discuss the current challenges facing the combination of PDT and multiple cancer treatment options, and we highlight the opportunities of nanoparticle-based PDT in cancer therapies.
Highlights
Each year, about 10 million people die of cancer, accounting for about one-sixth of the worldwide mortality, causing a high societal and economic burden [1]
Research has shown that surgery can induce the production of inflammatory mediators such as IL-6; these inflammatory cytokines can lower the effects of photodynamic therapy (PDT) by changing the tumor microenvironment and affecting the immune system [53]
The insights from the last several years increasingly support the idea that PDT is a powerful strategy for superficial cancer treatment, such as non-melanoma skin cancer, with advantages of minor damage, few side-effects, and precise treatment
Summary
About 10 million people die of cancer, accounting for about one-sixth of the worldwide mortality, causing a high societal and economic burden [1]. In photodynamic therapy (PDT), a light source is used in combination with a photosensitizer and oxygen in order to induce cell death. Pharmaceutics 2022, 14, 120 thereby providing energy for oxygen to generate reactive oxygen species (ROS), including hydrogen peroxide (H2 O2 ), superoxide anions (O2 − ), and hydroxyl radicals (OH− ), and singlet oxygen (1 O2 ) [4]. This destroys the organic constituents of the (tumor) cell structure, triggering apoptosis and necrosis of the cancer cells [5]. In light of the above, we provide a review of these PDT combination strategies and how nanomedicine can help to enhance the anticancer effects of these combinations
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