Photodynamic Therapy in Non-Gastrointestinal Thoracic Malignancies

Our plain-English summary of Photodynamic Therapy in Non-Gastrointestinal Thoracic Malignancies, by B. Kidane, D. Hirpara, K. Yasufuku (International Journal of Molecular Sciences, 2016).

The study

• Authors: B. Kidane, D. Hirpara, K. Yasufuku
• Journal: International Journal of Molecular Sciences
• Published: 2016;17(1)
• Type of article: Case report, Review
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Photodynamic therapy has a role in the management of early and late thoracic malignancies. It can be used to facilitate minimally-invasive treatment of early endobronchial tumours and also to palliate obstructive and bleeding effects of advanced endobronchial tumours. Photodynamic therapy has been used as a means of downsizing tumours to allow for resection, as well as reducing the extent of resection necessary. It has also been used successfully for minimally-invasive management of local recurrences, which is especially valuable for patients who are not eligible for radiation therapy. Photodynamic therapy has also shown promising results in mesothelioma and pleural-based metastatic disease. As new generation photosensitizers are being developed and tested and methodological issues continue to be addressed, the role of photodynamic therapy in thoracic malignancies continues to evolve.

In plain English

This article was a review of published research, not a new study. The authors summarized studies of photodynamic therapy (PDT), in which a light-sensitive drug is given and then activated by light aimed at the tumour. They covered chest cancers outside the digestive tract: non-small cell lung cancer, malignant pleural mesothelioma and cancer that had spread to the pleura. The article did not discuss asbestos. Among the reviewed studies, a phase III trial by Pass and colleagues randomized 63 patients with localized malignant pleural mesothelioma to multimodal treatment with or without PDT. That trial concluded that first-generation PDT had no impact on local control of disease or overall survival. A later trial by Friedberg and colleagues in 38 mesothelioma patients reported a 42-month median survival for epithelial histology after pleurectomy/decortication with PDT. The review noted serious complications such as esophageal fistulas. The authors concluded that PDT has shown promising results in mesothelioma and pleural-based metastatic disease. They cautioned that most of the lung cancer literature consisted of non-randomized case series and that "clinical response" had no standard definition.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of published studies (no new data collected)
• Who was studied: Published studies of patients with non-small cell lung cancer (early, radiographically occult, advanced and recurrent), malignant pleural mesothelioma, and pleural metastases. Study sizes ranged from single case reports to a 240-patient series. No asbestos-exposed population is described.
• Exposure: No asbestos or fiber exposure is studied. The subject is a treatment: photodynamic therapy using photosensitizers such as porfimer sodium (Photofrin), temoporfin (Foscan) and talaporfin sodium, often combined with surgery, chemotherapy or radiation.
• Main results:
  • In a reviewed phase III trial by Pass and colleagues, 63 patients with localized malignant pleural mesothelioma were randomized to multimodal treatment with or without PDT. That study concluded that first-generation PDT had no impact on local control of disease or overall survival.
  • In a reviewed phase I–II trial by Friedberg and colleagues of 38 mesothelioma patients, PDT after pleurectomy/decortication was followed by a 15-month median disease-free progression and a 42-month median survival time for epithelial histology.
  • The review reported esophageal fistulas as a serious, often delayed side effect of PDT inside the chest.
  • In a reviewed phase II trial of patients with pleural spread from non-small cell lung cancer treated with surgery and intraoperative PDT, local control of pleural disease at six months was seen in 73.3% of patients, and median survival was 21.7 months.
  • In a reviewed study by Chen and colleagues of 18 patients with thymoma or lung cancer spread to the pleura, lung cancer patients given PDT and surgery had a mean survival of 39.0 months, compared with 17.6 months in patients receiving chemotherapy (n = 51), p = 0.047.
  • In a reviewed randomized trial by Lam and colleagues in patients with obstructing, inoperable lung tumours, 70% (14/20) of the PDT plus radiotherapy group had complete clearance of airway obstruction, compared with 9.5% (2/21) of the radiotherapy-alone group.
• The authors' conclusion: The authors concluded that PDT has a role in managing early and late thoracic cancers and has shown promising results in mesothelioma and pleural-based metastatic disease, and that its role continues to evolve.
• Limitations the authors state:
  • Most of the lung cancer literature reviewed consisted of non-randomized case series, so the results should be interpreted with caution.
  • There is no standard definition of "clinical response", the main outcome in many studies.
  • PDT was often combined with other treatments in varying ways, making its independent effect hard to separate.
  • Loss to follow-up and the reasons for it were not reported consistently in most studies.
  • For mesothelioma, dose-related toxicity and procedure complications may preclude recommending PDT for widespread use.
  • In the pleural metastasis phase II trial, the effectiveness of PDT compared with a control group at the same centre is unknown.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• Low-dose photodynamic therapy promotes vascular E-selectin expression in chest malignancies, improving immune infiltration and tumor control — L.E. Chriqui, D.N. Marie, et al. (2025)
• Photodynamic therapy as adjuvant therapy in surgically treated pleural malignancies — P. Baas, L. Murrer, et al. (1997)
• Antibody drug conjugates in thoracic malignancies — J.M. Pacheco, D.R. Camidge (2018)
• A Novel Prospective Study Assessing the Combination of Photodynamic Therapy and Proton Radiation Therapy: Safety and Outcomes When Treating Malignant Pleural Mesothelioma — S.R. Rice, Y.R. Li, et al. (2019)
• Photodynamic therapy for malignant pleural mesothelioma: the future of treatment? — J.S. Friedberg (2011)
• The efficacy of immune checkpoint inhibitors in thoracic malignancies — J. Remon, F. Facchinetti, et al. (2021)

Browse more research in International Journal of Molecular Sciences, or return to medical research.