Abstract
Photoactive agents are promising complements for both early diagnosis and targeted treatment of cancer. The dual combination of diagnostics and therapeutics is known as theranostics. Photoactive theranostic agents are activated by a specific wavelength of light and emit another wavelength, which can be detected for imaging tumors, used to generate reactive oxygen species for ablating tumors, or both. Photodynamic therapy (PDT) combines photosensitizer (PS) accumulation and site-directed light irradiation for simultaneous imaging diagnostics and spatially targeted therapy. Although utilized since the early 1900s, advances in the fields of cancer biology, materials science, and nanomedicine have expanded photoactive agents to modern medical treatments. In this review we summarize the origins of PDT and the subsequent generations of PSs and analyze seminal research contributions that have provided insight into rational PS design, such as photophysics, modes of cell death, tumor-targeting mechanisms, and light dosing regimens. We highlight optimizable parameters that, with further exploration, can expand clinical applications of photoactive agents to revolutionize cancer diagnostics and treatment.
Highlights
Decreased cell viability by 20% with anti-human epidermal growth factor receptor 2 (Her2) antibodies targeting and high-contrast in vitro imaging aExperimental groups were exposed to different wavelengths to achieve the effects of the combined therapy. bSurface-functionalized carbon dot (CD) with l-tyrosine-tagged NDI derivative (NDI-i). cC60 loaded with iron oxide nanoparticle (IONP) and functionalized with PEG and folic acid (FA). dPAA-coated Cu2(OH)PO4 quantum dots. eAu-NRs coated with the pegylated mesoporous SiO2 to entrap the PS Ce6 and d-type cell-penetrating peptide (d-CPP). fPLGA biodegradable matrix loaded with the anticancer drug doxorubicin and covered with a porous Au-NS functionalized with human serum albumin (HSA), dye indocyanine green (ICG), and FA
OUTLOOK In this review, we have highlighted the scientific advances in photoactive theranostics that are expanding clinical Photodynamic therapy (PDT) and photodynamic diagnostic applications
Whether PDT is being used as a sensitizing agent, an immune activator, or the primary treatment, it will have different dosing windows depending on the combined therapy
Summary
Fluorescent agents are used for early diagnostics, as intraoperative markers in surgical resection, and for direct tumor treatment via PDT. PDT with various PSs is clinically approved for obstructive esophageal and lung cancers (worldwide), high-grade dysplasia in Barrett’s esophagus (worldwide), mild to moderate actinic keratosis (worldwide), basal cell carcinoma (worldwide), advanced head and neck cancer (European Union), cutaneous T cell lymphoma (European Union), biliary tract cancer (European Union), and prostate cancer (European Union).
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