Jefferson surgeons turning to light therapy for advanced lung cancer

November 06, 2002

Surgeons at Thomas Jefferson University Hospital in Philadelphia are finding success by combining light-based cancer therapy with surgery to treat patients with advanced lung cancer that has spread within the chest. While the number of patients treated to date is small, many patients are living three to four times longer than did those patients who did not receive the therapy.

Non-small cell lung cancer (NSCLC) is one of the most difficult cancers to treat, particularly when it spreads to the lining of the chest cavity. Even if the cancer is operated on, the disease returns in as many as 90 percent of patients. Survival frequently is measured in months. Results with chemotherapy - the current standard of care - are disappointing, with most patients living only between six and nine months.

Joseph Friedberg, M.D., is trying another way. Dr. Friedberg, chief of thoracic surgery at Thomas Jefferson University Hospital and Jefferson's Kimmel Cancer Center, is leading a clinical trial examining the effects of light, or more specifically, photodynamic therapy (PDT), on this type of advanced NSCLC. Such patients have cancer that has "broken out of one lung and seeded the lining of the chest cavity," he explains.

In PDT, a nontoxic photosensitizing agent, photofrin, is injected into the bloodstream and absorbed by cells all over the body. These compounds tend to concentrate more in cancer cells than in normal cells. When the compound is exposed to a certain wavelength of light, it absorbs the light energy and produces a form of oxygen that kills the cells. The damage occurs only where the light is shined.

In the study, each patient is given chemotherapy until the cancer stops responding, meaning the disease begins to grow again. If the cancer has not spread beyond the chest, the patient then receives photofrin 24 hours prior to surgery to remove the tumor. During surgery, he or she receives an appropriate dose of light therapy.

Of the 16 patients evaluated to date, at least one-half have lived more than 23 months, which is between three and four times the usual time.

The surgeons present their results November 6 at CHEST 2002, the annual meeting of the American College of Chest Physicians in San Diego.

The results, he says, have far surpassed expectations. "We had hoped the PDT would be effective in decreasing the local recurrence rate and it has," Dr. Friedberg says. "It surprised us that we appear to have made such an impact on survival.

"The numbers are small, and it's only preliminary," he says. "But if these results continue, this would be a significant advance in the treatment of this type of lung cancer."

Why they are seeing such good results is something of a mystery. PDT has typically been used by clinicians for treating small, easily seen tumors. The Jefferson trial for this type of lung cancer currently is the only one of its kind in the world.

"Traditionally, PDT has been used as a local therapy," Dr. Friedberg says. "The light passes only a few millimeters under the skin. It is approved by the Food and Drug Administration for use in endobronchial cancers, esophageal cancer and some skin cancers. It makes sense that it would reduce local recurrence rates, but why should it have such an apparently impressive impact on survival?"

Dr. Friedberg is hoping to use basic science research to better understand some of the cancer-killing effects of PDT he has seen in his patients. He is planning to collaborate with researchers at the University of Pennsylvania and at Roswell Park Cancer Institute in Buffalo to study the effects of photodynamic therapy on the immune system.

"We're the only ones doing this right now," he says. "And there's a lot of work and a lot of science left to do before we can validate these preliminary results and explain the favorable impact we are seeing."
-end-
Editors: This information is embargoed for presentation Nov. 6, 2002 at 3 p.m. ET at CHEST 2002, the annual meeting of the American College of Chest Physicians in San Diego.

Additional Contact Information:
Phyllis Fisher
215/955-6300
After Hours: 215/955-6060
E-Mail: steven.benowitz@mail.tju.edu

Thomas Jefferson University

Related Lung Cancer Articles from Brightsurf:

State-level lung cancer screening rates not aligned with lung cancer burden in the US
A new study reports that state-level lung cancer screening rates were not aligned with lung cancer burden.

The lung microbiome may affect lung cancer pathogenesis and prognosis
Enrichment of the lungs with oral commensal microbes was associated with advanced stage disease, worse prognosis, and tumor progression in patients with lung cancer, according to results from a study published in Cancer Discovery, a journal of the American Association for Cancer Research.

New analysis finds lung cancer screening reduces rates of lung cancer-specific death
Low-dose CT screening methods may prevent one death per 250 at-risk adults screened, according to a meta-analysis of eight randomized controlled clinical trials of lung cancer screening.

'Social smokers' face disproportionate risk of death from lung disease and lung cancer
'Social smokers' are more than twice as likely to die of lung disease and more than eight times as likely to die of lung cancer than non-smokers, according to research presented at the European Respiratory Society International Congress.

Lung cancer therapy may improve outcomes of metastatic brain cancer
A medication commonly used to treat non-small cell lung cancer that has spread, or metastasized, may have benefits for patients with metastatic brain cancers, suggests a new review and analysis led by researchers at St.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Lung transplant patients face elevated lung cancer risk
In an American Journal of Transplantation study, lung cancer risk was increased after lung transplantation, especially in the native (non-transplanted) lung of single lung transplant recipients.

Proposed cancer treatment may boost lung cancer stem cells, study warns
Epigenetic therapies -- targeting enzymes that alter what genes are turned on or off in a cell -- are of growing interest in the cancer field as a way of making a cancer less aggressive or less malignant.

Are you at risk for lung cancer?
This question isn't only for people who've smoked a lot.

Read More: Lung Cancer News and Lung Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.