Journal
ANTI-CANCER AGENTS IN MEDICINAL CHEMISTRY
Volume 21, Issue 2, Pages 123-136Publisher
BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/1871520620666200318101037
Keywords
Photodynamic therapy; anti-tumor immune response; T-lymphocytes; photosensitizer; adjuvants; DAMPS; tumor antigens
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Funding
- US NIH [R01AI050875, R21AI121700]
- South African Research Chairs Initiative of the Department of Science and Technology
- National Research Foundation of South Africa [98337]
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Photodynamic Therapy (PDT) is a cancer treatment that utilizes a photosensitizer to activate reactive oxygen species, killing tumor cells and stimulating the host immune system. Factors such as the structure of the photosensitizer, drug-light interval, rate of light delivery, and combination with adjuvants can affect the efficiency of the immune response. The success of checkpoint inhibitors in tumor immunotherapy opens up the possibility for investigating PDT in combination with other approaches in clinical scenarios.
Photodynamic Therapy (PDT) is a cancer therapy involving the systemic injection of a Photosensitizer (PS) that localizes to some extent in a tumor. After an appropriate time (ranging from minutes to days), the tumor is irradiated with red or near-infrared light either as a surface spot or by interstitial optical fibers. The PS is excited by the light to form a long-lived triplet state that can react with ambient oxygen to produce Reactive Oxygen Species (ROS) such as singlet oxygen and/or hydroxyl radicals, that kill tumor cells, destroy tumor blood vessels, and lead to tumor regression and necrosis. It has long been realized that in some cases, PDT can also stimulate the host immune system, leading to a systemic anti-tumor immune response that can also destroy distant metastases and guard against tumor recurrence. The present paper aims to cover some of the factors that can affect the likelihood and efficiency of this immune response. The structure of the PS, drug-light interval, rate of light delivery, mode of cancer cell death, expression of tumor-associated antigens, and combinations of PDT with various adjuvants all can play a role in stimulating the host immune system. Considering the recent revolution in tumor immunotherapy triggered by the success of checkpoint inhibitors, it appears that the time is ripe for PDT to be investigated in combination with other approaches in clinical scenarios.
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