| August 3, 2004
Penn Researchers Offer New Hope
to Advanced Stage Lung Cancer Patients
(Philadelphia, PA) - A new study that appears in the
June 2004 issue of the Journal of Clinical Oncology
shows that the life-expectancy of patients with advanced
stage lung cancer can be extended with the use of photodynamic
therapy, or PDT, in addition to surgical intervention.
Typically, advanced stage non-small cell lung cancer
patients have a median survival of 6-9 months when treated
with the current standard of care, chemotherapy alone.
However, this same set of patients demonstrated a median
survival of more than 22 months when chemotherapy was
combined with surgery and intraoperative PDT, a new
laser-based cancer treatment. Joseph S. Friedberg,
MD, Chief of Thoracic Surgery at Presbyterian-University
of Pennsylvania Medical Center, Stephen Hahn,
MD, Clinical Associate Professor of Radiation
Therapy and James P. Stevenson, MD,
Assistant Professor of Medicine are the co-investigators
in this trial at the University of Pennsylvania Medical
Center.
“We consider these results preliminary but extremely
encouraging. We expected PDT to make a difference in
the rate of local recurrence and it has,” says
Dr. Friedberg, “However, we did not anticipate
the dramatic increase in survival that we have observed.
In addition to the local control, there must be some
sort of systemic immune response that is contributing
to the enhanced survival we are observing in these patients
with a very advanced form of the disease. We are exploring
this phenomenon at a number of levels and feel we may
have stumbled upon the makings of a new immunologic
approach to treating patients with all stages of lung
cancer. It is an area of research about which we are
very excited and actively pursuing.”
In PDT, a nontoxic photosensitizing agent, Photofrin,
is injected into the blood stream and concentrates in
cancer cells, allowing the cancer to become very sensitive
to light. Using a laser to shine light on these cells
results in a very effective mechanism for killing cancer
cells. The damage occurs only where the light is shined,
limiting the harm to healthy tissue. PDT has rarely
been used in this way, combining it with other treatment
modalities, although it has been used by clinicians
for treating small, easily visualized tumors in the
windpipe and esophagus. Patients eligible for the treatment
are those whose cancer has spread within the chest cavity.
In the study, each patient is treated with chemotherapy
until the cancer stops responding, the normal course
for this disease and the limitation of chemotherapy
alone. After it is confirmed that the cancer has not
spread beyond the chest cavity, the patient then receives
Photofrin 24 hours prior to surgery. During surgery,
the cancer is removed, which may involve excising all
or part of the affected lung. Then, surgeons shine a
laser into the chest cavity, giving the appropriate
dose of light in an effort to kill any remaining microscopic
tumor cells that remain after surgery.
It is known that surgery, without PDT, will almost
certainly be accompanied by a high rate of local recurrence,
likely a result of the invisible remaining disease being
targeted with PDT. The treatment has proven very safe,
largely as a function of using a specially designed
computer system to measure and monitor the amount of
laser light delivered at the time of treatment.
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