Photodynamic therapy (PDT) using HPPH for the treatment of precancerous lesions associated with barrett's esophagus

• DOI: 10.1002/lsm.21112
• Publication Date: 2015-10-13T06:02:52Z
• Authors: Hector R. Nava; Shyam S. Allamaneni; Thomas J. Dougherty; Michele T. Cooper; Wei Tan; Gregory Wilding; Barbara W. Henderson
• Keywords: Aged, 80 and over; Chlorophyll; Male; Photosensitizing Agents; Dose-Response Relationship, Drug; Esophageal Neoplasms; Dose-Response Relationship, Radiation; Adenocarcinoma; Middle Aged; Drug Administration Schedule; 3. Good health; Barrett Esophagus; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Photochemotherapy; Humans; Female; Esophagoscopy; Infusions, Intravenous; Precancerous Conditions; Aged

Background and Objectives Photodynamic therapy (PDT) with porfimer sodium, FDA approved to treat premalignant lesions in Barrett's esophagus, causes photosensitivity for 6–8 weeks. HPPH (2-[1-hexyloxyethyl]-2-devinyl pyropheophorbide-a) shows minimal photosensitization of short duration promising efficacy preclinical studies. Here we explore toxicity optimal drug light dose endoscopic HPPH-PDT. We also want know the one time treatment Study Design/Materials Methods Two nonrandomized escalation studies were performed (18 patients each) biopsy-proven high grade dysplasia or early intramucosal adenocarcinoma esophagus. doses ranged from 3 6 mg/m2. At 24 48 hours after administration received exposure 150, 175, 200 J/cm 665 nm light. Results Most experienced mild moderate chest pain requiring symptomatic only. Six 4 adverse events (16.6%). Three esophageal strictures treated dilatation. No clear pattern dependence toxicities emerged. In ranging study (light 150 at hours), mg/m2 emerged as most effective. (3 HPPH, complete response rates (disappearance carcinoma) 72% achieved 1 year, all plus 175 showing responses year. Conclusions HPPH-PDT precancerous esophagus appears be safe efficacy. Further clinical are required establish use Lasers Surg. Med. 43:705–712, 2011. © 2011 Wiley-Liss, Inc.