title: Phase I/II study of verteporfin photodynamic therapy in locally advanced pancreatic cancer.
abstract: BACKGROUND
  Patients with pancreatic cancer have a poor prognosis apart from the few suitable for surgery. Photodynamic therapy (PDT) produces localised tissue necrosis but previous studies using the photosensitiser meso-tetrahydroxyphenylchlorin (mTHPC) caused prolonged skin photosensitivity. This study assessed a shorter acting photosensitiser, verteporfin.
  
  
  METHODS
  Fifteen inoperable patients with locally advanced cancers were sensitised with 0.4 mg kg(-1) verteporfin. After 60-90 min, laser light (690 nm) was delivered via single (13 patients) or multiple (2 patients) fibres positioned percutaneously under computed tomography (CT) guidance, the light dose escalating (initially 5 J, doubling after each three patients) until 12 mm of necrosis was achieved consistently.
  
  
  RESULTS
  In all, 12 mm lesions were seen consistently at 40 J, but with considerable variation in necrosis volume (mean volume 3.5 cm(3) at 40 J). Minor, self-limiting extrapancreatic effects were seen in multifibre patients. No adverse interactions were seen in patients given chemotherapy or radiotherapy before or after PDT. After PDT, one patient underwent an R0 Whipple's pancreaticoduodenectomy.
  
  
  CONCLUSIONS
  Verteporfin PDT-induced tumour necrosis in locally advanced pancreatic cancer is feasible and safe. It can be delivered with a much shorter drug light interval and with less photosensitivity than with older compounds.
authors.affiliation: UCL Institute for Liver and Digestive Health, University College London, UCL Medical School-Royal Free Hospital Campus, U3 Floor, Pond Street, London NW3 2QG, UK.
authors.forename: M T
authors.initials: MT
authors.lastname: Huggett
authors.affiliation: Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA.
authors.forename: M
authors.initials: M
authors.lastname: Jermyn
authors.affiliation: Department of Radiology, University College Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Gillams
authors.affiliation: Department of Radiology, University College Hospital, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Illing
authors.affiliation: National Medical Laser Centre, University College London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Mosse
authors.affiliation: Department of Pathology, University College Hospital, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Novelli
authors.affiliation: UCLH Cancer Clinical Trials Unit, University College Hospital, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Kent
authors.affiliation: National Medical Laser Centre, University College London, London, UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Bown
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: T
authors.initials: T
authors.lastname: Hasan
authors.affiliation: Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA.
authors.forename: B W
authors.initials: BW
authors.lastname: Pogue
authors.affiliation: UCL Institute for Liver and Digestive Health, University College London, UCL Medical School-Royal Free Hospital Campus, U3 Floor, Pond Street, London NW3 2QG, UK.
authors.forename: S P
authors.initials: SP
authors.lastname: Pereira
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000368:Aged; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D010778:Photochemotherapy / Q000009:adverse effects; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D000077362:Verteporfin
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin