Gold nanoshell-localized photothermal ablation of prostate tumors in a clinical pilot device study
Gold nanoshell-localized photothermal ablation of prostate tumors in a clinical pilot device study
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临床试验装置研究中金纳米壳局部光热消融前列腺肿瘤
DOI：
10.1073/pnas.1906929116
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发表时间：
2019-09-10
影响因子：
11.1
通讯作者：
Halas, Naomi J.
中科院分区：
文献类型：
--
作者：
Rastinehad, Ardeshir R.;Anastos, Harry;Halas, Naomi J.
设计用于吸收高组织透明度波长的光的生物相容性金纳米颗粒在生物医学应用中受到特别关注。这种纳米粒子将吸收的近红外光转化为热量并诱导高度局部高温的能力已被证明对于光热癌症治疗非常有效，导致多种临床前动物模型中的细胞死亡和肿瘤缓解。在这里，我们报告了一项临床试验的初步结果，其中激光激发金二氧化硅纳米壳（GSN）与磁共振超声融合成像相结合，可局部消融前列腺内的低中度肿瘤。总体目标是对前列腺癌进行高度局部化的区域控制，从而大大降低患者的发病率并改善功能结果。这项试点设备研究报告了 16 例诊断为低风险或中风险局限性前列腺癌患者的可行性和安全性数据。 GSN 输注和高精度激光消融后，患者在 48 至 72 小时接受前列腺多参数 MRI，随后在术后 3 个月和 12 个月进行 mpMRI/超声靶向融合活检，并在 12 个月时进行标准 12 核系统活检。 94%（15/16）的患者成功实现了 GSN 介导的聚焦激光消融，治疗后观察到的国际前列腺症状评分或男性性健康量表没有显着差异。对于患有低风险或中风险局限性前列腺癌的男性来说，这种治疗方案似乎是可行且安全的，不会出现严重并发症或泌尿生殖功能的有害变化。
Biocompatible gold nanoparticles designed to absorb light at wavelengths of high tissue transparency have been of particular interest for biomedical applications. The ability of such nanoparticles to convert absorbed near-infrared light to heat and induce highly localized hyperthermia has been shown to be highly effective for photothermal cancer therapy, resulting in cell death and tumor remission in a multitude of preclinical animal models. Here we report the initial results of a clinical trial in which laser-excited gold-silica nanoshells (GSNs) were used in combination with magnetic resonance-ultrasound fusion imaging to focally ablate low-intermediate-grade tumors within the prostate. The overall goal is to provide highly localized regional control of prostate cancer that also results in greatly reduced patient morbidity and improved functional outcomes. This pilot device study reports feasibility and safety data from 16 cases of patients diagnosed with low-or intermediate-risk localized prostate cancer. After GSN infusion and high-precision laser ablation, patients underwent multiparametric MRI of the prostate at 48 to 72 h, followed by postprocedure mpMRI/ultrasound targeted fusion biopsies at 3 and 12 mo, as well as a standard 12-core systematic biopsy at 12 mo. GSN-mediated focal laser ablation was successfully achieved in 94% (15/16) of patients, with no significant difference in International Prostate Symptom Score or Sexual Health Inventory for Men observed after treatment. This treatment protocol appears to be feasible and safe in men with low-or intermediate-risk localized prostate cancer without serious complications or deleterious changes in genitourinary function.