Clinical investigation of the novel iron-chelating agent, CP94, to enhance topical photodynamic therapy of nodular basal cell carcinoma
Clinical investigation of the novel iron-chelating agent, CP94, to enhance topical photodynamic therapy of nodular basal cell carcinoma
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DOI：
10.1111/j.1365-2133.2008.08668.x
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发表时间：
2008-08-01
影响因子：
10.3
通讯作者：
Curnow, A.
中科院分区：
文献类型：
--
作者：
Campbell, S. M.;Morton, C. A.;Curnow, A.
背景光动力疗法（PDT）涉及通过可见光激活光敏剂，在靶细胞内产生活性氧，从而破坏它们。循证指南支持局部使用 5-氨基乙酰丙酸 (ALA-PDT) 进行光动力治疗 (PDT) 对光化性角化病、鲍文病和基底细胞癌 (BCC) 的疗效。除非事先进行减瘤或重复治疗，否则结节性 BCC 的疗效似乎不如浅表性 BCC。 目的 本研究的目的是评估在局部 ALA 中添加新型铁螯合剂 CP94（1,2-二乙基-3-羟基吡啶-4-酮盐酸盐）以暂时增加肿瘤中光敏剂的积累的安全性和有效性。方法 ALA + 增加的混合局部制剂使用标准光传输，使用不同浓度的 CP94 对先前活检的结节性 BCC 进行 PDT，而无需事先进行病变准备。对该区域进行临床评估，并在 6 周后手术切除进行组织学检查。 结果 在我们的单次治疗 PDT 方案中，使用 40% CP94 的增强型 PDT 与单独使用 ALA-PDT 相比，在结节性 BCC 中的清除率显着更高，无需进行病灶准备。 结论 本研究的结果表明，使用 CP94 的增强型 ALA-PDT 方案治疗结节性 BCC 是安全有效的，这种修改没有出现不良反应。这是该制剂首次用于患者。该公式现在是进一步研究的重点。
Background Photodynamic therapy (PDT) involves the activation of a photosensitizer by visible light to produce activated oxygen species within target cells, resulting in their destruction. Evidence-based guidelines support the efficacy of PDT using topical 5-aminolaevulinic acid (ALA-PDT) in actinic keratoses, Bowen disease and basal cell carcinoma (BCC). Efficacy for nodular BCC appears inferior to that for superficial BCC unless prior debulking or repeat treatments are performed.Objectives The aim of this study was to assess the safety and efficacy of adding a novel iron-chelating agent, CP94 (1,2-diethyl-3-hydroxypyridin-4-one hydrochloride), to topical ALA, to temporarily increase the accumulation of the photosensitizer in the tumour.Methods A mixed topical formulation of ALA + increasing concentrations of CP94 was used to carry out PDT on previously biopsied nodular BCC with no prior lesion preparation using standard light delivery. The area was assessed clinically and surgically excised 6 weeks later for histological examination.Results Enhanced PDT using 40% CP94 resulted in significantly greater clearance rates in nodular BCC than with ALA-PDT alone, in our protocol of single-treatment PDT with no lesion preparation.Conclusions The results of this study demonstrate the safe and effective use of an enhanced ALA-PDT protocol for nodular BCC using CP94, with no adverse reactions to this modification. This is the first time this formulation has been used in patients. This formulation is now the focus of further study.