Techniques for delivery and monitoring of TOOKAD (WST09)-mediated photodynamic therapy of the prostate: clinical experience and practicalities.
Photodynamic therapy of solid organs requires sufficient PDT dose throughout the target tissue while minimizing the dose to proximal normal structures. This requires treatment planning for position and power of the multiple delivery channels, complemented by on-line monitoring during treatment of light delivery, drug concentration and oxygen levels. We describe our experience in implementing this approach in Phase I/II clinical trials of the Pd-bacteriophephorbide photosensitizer TOOKAD (WST09)-mediated PDT of recurrent prostate cancer following radiation failure. We present several techniques for delivery and monitoring of photodynamic therapy, including beam splitters for light delivery to multiple delivery fibers, multi-channel light dosimetry devices for monitoring the fluence rate in the prostate and surrounding organs, methods of measuring the tissue optical properties in situ, and optical spectroscopy for monitoring drug pharmacokinetics of TOOKAD in whole blood samples and in situ in the prostate. Since TOOKAD is a vascular-targeted agent, the design and implementation of the techniques are different than for cellular-targeted agents. Further development of these delivery and monitoring techniques will permit full on-line monitoring of the treatment that will enable real-time, patient-specific and optimized delivery of PDT.
Weersink
Robert A
RA
Laboratory for Applied Biophotonics, University Health Network, University Avenue, Toronto, Canada. weersink@uhnres.utoronto.ca
Bogaards
Arjen
A
Gertner
Mark
M
Davidson
Sean R H
SR
Zhang
Kai
K
Netchev
George
G
Trachtenberg
John
J
Wilson
Brian C
BC
D001429:Bacteriochlorophylls / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002138:Calibration; D002986:Clinical Trials as Topic / Q000379:methods*; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D008297:Male; D010084:Oxidation-Reduction / Q000187:drug effects; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011467:Prostate / Q000000981:diagnostic imaging / Q000378:metabolism*; D011874:Radiometry; D013053:Spectrophotometry; D014463:Ultrasonography
D001429:Bacteriochlorophylls; D017319:Photosensitizing Agents; C456120:palladium-bacteriopheophorbide