“Photodynamic therapy (PDT) is a novel therapy but not an unknown therapy,” stated Susan Moffatt-Bruce, MD, PhD, of the Division of Thoracic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. With a background in transplant immunology, Dr. Moffatt-Bruce has turned to her current research on the use of PDT for relieving the symptoms of endobronchial disease in patients with lung cancer. Dr. Moffatt-Bruce shared the very early findings of her current study to determine whether the immune response in patients with non–small cell lung cancer (NSCLC) treated with PDT is T-cell mediated. She briefly explored the ongoing journey to clarify the immunologic response of PDT in patients with lung cancer in the hope of optimizing the ability to predict patient outcomes and translating the defined immune profile of PDT treatment in lung cancer into effective therapeutic interventions.
One review served as a background for the rationale behind exploring the immunologic consequences of PDT in cancer treatment.1 van Duijnhoven et al.1 addressed the effect of PDT on the immune response in patients with solid tumors. They suggested that through destroying the structure of a tumor, PDT enables direct interaction between immune cells and tumor cells; this type of “in situ vaccination” induces a systemic antitumor immune response.1
Another retrospective review (coauthored by Dr. Moffatt-Bruce’s colleague and mentor Dr. Patrick Ross)2 focused on the incorporation of PDT into the induction therapy regimen for locally advanced primary nonmetastatic NSCLC bronchogenic carcinoma. Fifty percent of patients initially deemed unresectable were able to undergo definitive surgical resection after trimodality induction therapy consisting of PDT with chemotherapy and/or irradiation.2 In addition, 27% of patients considered to require pneumonectomy were able to have a lobectomy after trimodality induction therapy.2 Finally, the pathologic stage was less than the preinduction clinical stage in 14 of 22 cases, of which 4 patients had no residual tumor.2
van Duijnhoven FH, Aalbers RI, Rovers JP et al. . The immunological consequences of photodynamic treatment of cancer, a literature review. Immunobiology 2003;207:105–113.
Ross P Jr, Grecula J, Bekaii-Saab T et al. . Incorporation of photodynamic therapy as an induction modality in non-small cell lung cancer. Lasers Surg Med 2006;38:881–889.
Moffatt-Bruce S. Photodynamic therapy using porfimer sodium in treating patients with non-small cell lung cancer and bronchial disease. http://clinicaltrials.gov/ct/show/NCT00754910. Accessed May 29, 2012.