OBJECTIVE: To determine the optimal drug and light dose for prostate ablation using WST11 (TOOKAD® Soluble) for Vascular Targeted Photodynamic (VTP) therapy in men with low-risk prostate cancer.
PATIENTS AND METHODS: Forty men received a single dose of 2, 4 or 6mg/kg WST11 activated by 200J/cm light at 753 nm. WST-11 was given as a 10 minute intravenous infusion. The light dose was delivered using cylindrical diffusing fibres within hollow plastic needles positioned in the prostate using transrectal ultrasound scan (TRUS) guidance and a brachytherapy template. Magnetic resonance imaging (MRI) was used to assess treatment effect at 7 days, with assessment of urinary function (International Prostate Symptom Score [IPSS]), sexual function (International Index of Erectile Function [IIEF]) and adverse events at 7 days, 1, 3 and 6 months. TRUS guided biopsy was performed at 6 months.
RESULTS: Thirty-nine of 40 treated men completed follow up. The Day 7 MRI showed maximal treatment effect (95% of the planned treatment volume) in men who had a WST11 dose of 4mg/kg, light dose of 200J/cm and light density index (LDI) of >1. In the 12 men treated with these parameters, the negative biopsy rate was 10/12 (83%) at 6 months, compared to 45% (10/26) for the men who had either different drug doses (n=10), or an LDI of < 1 (n=16). Transient urinary symptoms were seen in the majority of men, with no significant difference in IPSS score between baseline and 6 months. IIEF scores were not significantly different between baseline and 6 months.
CONCLUSION: 4mg/kg TOOKAD® Soluble activated by 753nm light at a dose of 200J/cm and an LDI >1 resulted in treatment effect in 95% of the planned treatment volume and a negative biopsy rate at 6 months of 83% in a group of 12 men.
Written by:
Moore CM, Azzouzi AR, Barret E, Villers A, Muir G, Barber N, Trachtenberg J, Arumainayagam N, Gaillac B, Allen C, Schertz A, Emberton M. Are you the author?
Division of Surgery and Interventional Science, University College London, UK.
Reference: BJU Int. 2014 May 19. Epub ahead of print.
doi: 10.1111/bju.12816
PubMed Abstract
PMID: 24841929
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