There has been significant effort over the past two decades in the treatment of malignancies of epithelial origin,
including some of the most devastating of cancers, such as colorectal cancer (CRC), squamous call carcinoma of the
head and neck (HNSCC), and carcinomas of the pancreas, lungs, (both Small Cell and Non-Small Cell), renal cell,
prostate, bladder and breast. Recurring, refractory HNSCC is a particularly difficult cancer to treat once the tumors
recur due to mutations that are resistant to repeat chemotherapy and radiation. In addition, repeat surgery is often
difficult due to the requirement of significant surgical margins that may not be possible due to the attending potential
functional deficits (e.g., salivary glands, nerves and major blood vessels in confined areas). In this study FaDu HNSCC
xenograft tumors in SCID mice were imaged, and “optical”, as opposed to “surgical” margins defined for the tumor
being treated. The subsequent two-photon treatment irradiation was computer-controlled to carry out the tumor
treatment by rastering the laser beam throughout the tumor volume plus the defined optical margins simultaneously. In
our initial studies, up to 85% regression in tumor volume was observed in 5 days post PDT, with complete tumor
regression in 18 days. No re-growth was observed up to 41 days post-PDT, with little or no scarring and complete hair
re-growth. However, competition between imaging and PDT moieties was also observed in some mouse models,
possibly favoring tumor re-growth. Strategies to selectively optimize the PDT effect will be discussed.
Synthesis of new PDT triads that incorporate a tumor-killing porphyrin with large two-photon cross-section for 150 fs
laser pulses (2000 GM) in the Near-infrared (NIR) at 840 nm, a NIR imaging agent, and a small peptide that targets
over-expressed EGF receptors on the tumor surface. This triad formulation has been optimized over the past year to
treat FADU Head and Neck SCC xenograft tumors in SCID mice. Effective PDT triad dose (1-10 mg/Kg) and laser
operating parameters (840 nm, 15-45 min, 900 mW) have been established. Light, dark and PDT treatment toxicities
were determined, showing no adverse effects. Previous experiments in phantom and mouse models indicate that tumors
can be treated directly through the skin to effective depths between 2 and 5 cm. Treated mice demonstrated rapid tumor
regression with some complete cures in as little as 15-20 days. No adverse effects were observed in any healthy tissue
through which the focused laser beam passed before reaching the tumor site, and excellent healing occurred post
treatment including rapid hair re-growth. Not all irradiation protocols lead to complete cures. Since two-photon PDT is
carried out by rastering focused irradiation throughout the tumor, there is the possibility that as the treatment depth
increases, some parts of the tumor may escape irradiation due to increased scattering, thus raising the possibility that
tumor re-growth could be triggered by small islands of untreated cells, especially at the rapidly growing tumor margins,
a problem we hope to alleviate by using image-guided two-photon PDT.
We present a novel way of optical detection of malignant cancer cell colonies by using multi-wavelength two-photon
excited fluorescence from an environmentally sensitive Styryl-9M dye. We show that the two-photon excited
fluorescence from colonies embedded in a tissue phantom depends on the type of cells as well as on the composition of
the phantoms. We use the ratio between the fluorescence intensities excited at 1100 and 1200 nm to distinguish between
samples containing no cell colonies, samples with colonies of normal cells and samples with cancer cells. The proposed
method is a promising tool for non-invasive deep tissue photodetection diagnostics and for precise localization of
malignant cells.
We present a novel way of optical detection of malignant cancer cell colonies by using multi-wavelength two-photon
excited fluorescence from an environmentally sensitive Styryl-9M dye. We show that the two-photon excited
fluorescence from colonies embedded in a tissue phantom depends on the type of cells as well as on the composition of
the phantoms. We use the ratio between the fluorescence intensities excited at 1100 and 1200 nm to distinguish between
samples containing no cell colonies, samples with colonies of normal cells and samples with cancer cells. The proposed
method is a promising tool for non-invasive deep tissue photodetection diagnostics and for precise localization of
malignant cells.
New porphyrin-based photo-sensitizers have been designed, synthesized and characterized that exhibit greatly enhanced
intrinsic two-photon absorption. These new photo-sensitizers have been incorporated into triad formulations that also
incorporate Near-infrared (NIR) imaging agents, and small-molecule targeting agents that direct the triads to cancerous
tumors' over-expressed receptor sites. PDT can be initiated deep into the tissue transparency window at 780-800 nm
utilizing a regeneratively amplified Ti:sapphire laser using 100-150 fs pulses of 600-800 mW. Human tumor xenografts
of human breast cancer (MDA-MB-231) and both small SCLC (NCI-H69) and NSCLC (A-459) have been successfully
treated using octreotate targeting of over-expressed SST2 receptors. In particular, the lung cancer xenografts can be
successfully treated by irradiating from the side of the mouse opposite the implanted tumor, thereby passing through ca.
2 cm of mouse skin, tissue and organs with no discernible damage to healthy tissue while causing regression in the
tumors. These results suggest a new PDT paradigm for the noninvasive treatment of subcutaneous tumors, including the
possibility that the targeting moiety could be matched to individual patient genetic profiles (patient-specific
therapeutics).
We present a detailed study of the local environmental sensitivity of the commercially available laser dye, Styryl-9M.
Positions of the one-photon and two-photon absorption maxima and
two-photon absorption minimum of the dye are
sensitive to the solvent polarity. In aqueous solution its absorption and fluorescence spectra consist of two peaks whose
relative strength depend on the surrounding pH-s. The dye shows one of the highest two-photon absorption cross
sections, 700-1300 GM at the peak, among widely available compounds. Comparison of the linear and nonlinear
properties shows that its maximum cross section can be described by an effective two-level model. Based on the
properties of Styryl-9M we propose a new method of sensing local environment polarity in solutions and biological phantoms. We show that the dye is a promising candidate for two-photon biological imaging and microscopy.
Over the past three years we have described the rationale for using new photosensitizers (PS) with greatly enhanced
multi-photon absorption. In particular, we have synthesized new porphyrin-based photosensitizers that also incorporate
small molecule targeting agents that direct the ensemble to over-expressed tumor receptor sites, as well as Near-infrared
imaging agents that will allow practical image-guided two-photon PDT in the tissue transparency window (750-1000
nm) at laser fluences that are harmless to surrounding healthy tissue. We have previously shown (PW2006) successful
treatment of human breast cancer models (MDA-MB-231) in SCID mice, and have recently extended these studies to the
treatment of both human small cell (SC) (NCI-H69) and non-small cell (NSC) (A-459) models in SCID mice. We have
demonstrated that lung cancer xenografts can be successfully treated by irradiating from the side of the mouse opposite
the implanted tumor, thereby passing through ca. 2 cm of mouse skin, tissue and organs before encountering the bulk
tumor. These results suggest that this technology can be used to treat deep subcutaneous spontaneous tumors in larger
animal models (e.g. canine). We would also emphasize that the synthetic route to these triads attaches the targeting
moiety in the last step of the synthesis, and can be easily changed, thus allowing a myriad of targeting agents to be
employed, opening the door to the possibility of patient-specific PDT.
A novel class of porphyrin-based near-infrared photodynamic therapy (PDT) sensitizers is studied. We achieve regressions of human small cell lung cancer (NCI-H69), non-small cell lung cancer (A 459) and breast cancer (MDAMB- 231) xenografts in SCID mice at significant tissue depth by irradiation with an amplified femtosecond pulsed laser at 800 nm wavelength. Significant tumor regressions were observed during the first 10-14 days post treatment. Tumor histopathology was consistent with known PDT effects, while no significant changes were noted in irradiated normal tissues. In vivo imaging studies using intravenous injections of fluorescent dextran demonstrated an early loss of tumor blood flow. RNA was isolated from NCI-H69 PDT treated SCID mouse xenografts and paired untreated xenografts at 4 hours post laser irradiation. Similarly RNA was isolated from PDT treated and untreated Lewis lung carcinomas growing in C57/Bl6 mice. Expression profiling was carried out using AffymetrixTM human and mouse GeneChips®. Cluster analysis of microarray expression profiling results demonstrated reproducible increases in transcripts associated with apoptosis, stress, oxygen transport and gene regulation in the PDT treated NCI-H69 samples. In addition, PDT treated Lewis lung carcinomas showed reproducible increases in transcripts associated with immune response and lipid biosynthesis. PDT treated C57/Bl6 mice developed cytotoxic T cell activity towards this tumor, while untreated tumor bearing mice failed to do so.
Photodynamic therapy (PDT) continues to evolve into a mature clinical treatment of a variety of cancer types as well as
age-related macular degeneration of the eye. However, there are still aspects of PDT that need to be improved in order
for greater clinical acceptance. While a number of new PDT photo-sensitizers, sometimes referred to as second- or third-
generation therapeutic agents, are currently under clinical investigation, the direct treatment through the skin of
subcutaneous tumors deeper than 5 mm remains problematic. Currently approved PDT porphyrin photo-sensitizers, as
well as several modified porphyrins (e.g. chlorins, bacteriochlorins, etc.) that are under clinical investigation can be
activated at 630-730 nm, but none above 800 nm. It would be highly desirable if new PDT paradigms could be
developed that would allow photo-activation deep in the tissue transparency window in the Near-infrared (NIR) above
800 nm to reduce scattering and absorption phenomena that reduce deep tissue PDT efficacy. Rasiris and MPA
Technologies have developed new porphyrins that have greatly enhanced two-photon absorption ( P A ) cross-sections
and can be activated deep in the NIR (ca. 780-850 nm). These porphyrins can be incorporated into a therapeutic triad that
also employs an small molecule targeting agent that directs the triad to over-expressed tumor receptor sites, and a NIR
onephoton imaging agent that allows tracking the delivery of the triad to the tumor site, as well as clearance of excess
triad from healthy tissue prior to the start of PDT treatment. We are currently using these new triads in efficacy studies
with a breast cancer cell line that has been transfected with luciferase genes that allow implanted tumor growth and post-
PDT treatment efficacy studies in SCID mouse models by following the rise and decay of the bioluminescence signal.
We have also designed highly absorbing and scattering collagen breast cancer phantoms in which we have demonstrated
dramatic cell kill to a depth of at least 4 cm. We have also demonstrated that at the wavelength and laser fluences used in
the treatment of implanted tumors in the mouse mammary fat pads, there is little, if any, damage to the skin or internal
mouse organs. In addition, we have also demonstrated that the implanted tumors can be treated to a depth of more than 1
cm by direct radiation through the dorsal side of the mouse.
Photodynamic therapy (PDT) has developed into a mature technology over the past several years, and is currently being exploited for the treatment of a variety of cancerous tumors, and more recently for age-related wet macular degeneration of the eye. However, there are still some unresolved problems with PDT that are retarding a more general acceptance in clinical settings, and thus, for the most part, the treatment of most cancerous rumors still involves some combination of invasive surgery, chemotherapy and radiation treatment, particularly subcutaneous tumors. Currently approved PDT agents are activated in the Visible portion of the spectrum below 700 nm, Laser light in this spectral region cannot penetrate the skin more than a few millimeters, and it would be more desirable if PDT could be initiated deep in the Near-infrared (NIR) in the tissue transparency window (700-1000 nm). MPA Technologies, Inc. and Rasiris, Inc. have been co-developing new porphyrin PDT designed to have greatly enhanced intrinsic two-photon cross-sections (>800 GM units) whose two-photon absorption maxima lie deep in the tissue transparency window (ca. 780-850 nm), and have solubility characteristics that would allow for direct IV injection into animal models. Classical PDT also suffers from the lengthy time necessary for accumulation at the tumor site, a relative lack of discrimination between healthy and diseased tissue, particularly at the tumor margins, and difficulty in clearing from the system in a reasonable amount of time post-PDT. We have recently discovered a new design paradigm for the delivery of our two-photon activated PDT agents by incorporating the porphyrins into a triad ensemble that includes a small molecule targeting agent that directs the triad to over-expressed tumor receptor sites, and a NIR one-photon imaging agent that allows the tracking of the triad in terms of accumulation and clearance rates. We are currently using these new two-photon PDT triads in efficacy studies with two breast cancer cell lines, both in vitro and in vivo. Both of these cell lines have been transfected with luciferase genes that allow implanted tumor growth and PDT efficacy to be monitored in living mouse models over time by following the rise and decay of the bioluminescence signals.
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