Photodynamic Therapy to Fight Glioblastoma Multiforme

Here we are at the sixteenth episode of Ben Williams’ guide translation project on treatment options for Glioblastoma Multiforme. This is chapter 12 of the guide. In this episode we talk about photodynamic therapy which is a therapy that uses photosensitizers and laser light during the surgical treatment. The advice is still to use this information to discuss it with the medical team that is following you. You can point them the references to supporting scientific works.
In the next episode we will start talking about treatments for recurrent Glioblastoma.
The Glioblastoma.it for CUSP-ND for Emanuele  fundraising campaign continues. Last week I was invited to the RADAR radio broadcast of the regional RAI of Friuli Venezia Giulia (Podcast della Puntata del 9 Marzo 2021) and to the Trieste Live broadcast of Tele 4, a local television station  (Video Registrazione della Puntata del 16 Marzo 2021). Share the link in order to raise awareness as many people as possible. Enjoy the reading!

Photodynamic therapy

When brain tumor cells absorb a molecule called hematoporphyrin (and other photosensitizers), exposure to high intensity laser light will be able to kill them. A treatment based on this logic was developed in Australia, and has been used both in Australia and in some centers in Europe, but not yet in the United States. Early results with this approach weren’t exceptional, but the most recent report on clinical trial results in newly diagnosed high-grade glioma patients indicates greater success. For patients with AA-III tumors, the median survival was 77 months while that for patients with glioblastoma was 14 months (222). More impressive were the long-term survival rates, as 73% of grade III patients survived for more than 3 years, as did 25% of glioblastoma patients. The results on patients with recurrent tumors were also remarkable. Median survival was 67 months for patients with AA-III and 14.9 months for GBM. 41% of patients with recurrent GBM survived beyond 24 months and 37% beyond 36 months. However, a review (223) of six different clinical studies on this procedure indicated a wide variability in the results, with an aggregate median survival for newly diagnosed GBM of 14.3 months and for recurrent GBM tumors of 10 months. The treatment has been reported to have minimal toxicity.
More positive results were obtained from a Japanese study using a new photosensitizer called sodium talaporfin (224), followed by the standard Stupp protocol. For 13 newly diagnosed GBM patients, the median PFS was 12 months and the median overall survival was 25 months, a substantial improvement over the Stupp protocol alone.
Work presented at the 2015 SNO annual conference by a Japanese team provided further details on this phase II study of photodynamic therapy for malignant glioma conducted between 2009 and 2012 (345). The study involved 27 patients, including 13 with glioblastoma. A median survival of 31.5 months and a median progression-free survival of 19.6 months have been reported, although in fairness, the results for patients with grade 3 glioma should be provided separately from the results for patients with GBM. Most significantly, tumor resection and photodynamic therapy for 16 patients with recurrent glioblastoma resulted in a one-year survival rate of 77.1% and a median survival of 13.8 months, which compares favorably with others studies related to recurrent glioblastoma. Only patients with resectable superficial tumors are eligible for such treatment.

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(222) Stylli, S. S., et al. Photodynamic therapy of high-grade glioma – long-term survival. J. Clin Neuroscience, 2005, 12 (4) 389-398. 
(223) Kostron, H. Photodynamic diagnosis and therapy and the brain. Methods Mol. Biol. 2010, 635, 261-280.
(224) Muragaki, Y, Akimoto, J., Maruyama, T., et al. Phase II clinical study on intraoperative photodynamic therapy with talaporfin sodium and semiconductor lasers in patients with malignant brain tumors. Journal of Neurosurgery, 2013, 119,845-52. 
(345) Nitta, Masayuki et al. “ATCT-24 Role of photodynamic therapy (PDT) for glioblastoma.” Neuro-Oncology 17.suppl 5 (2015): v6-v7.

I hope you enjoyed reading, I was as faithful as possible. Soon the next chapter! See you soon!