It's such a shame that Theralase does not have the resources to take advantage of even a small part of the amazing research that is going on. In this paper, Dr. Lilge and colleagues lay the groundwork for treating spinal metastases with photodynamic therapy. A phase 1 trial has already demonstrated that pdt of this condition with BPD-MA (aka Visudyne aka Verteporfin for injection - approved by the FDA as a photosensitizer for age-related macular degeneration) is safe. As usual Dr. Lilge et al. are trying to make clinical trials of oncological pdt practical by maximizing destruction of tumours while minimizing destruction of healthy tissue. TLD1433 is a far better pdc than Visudyne but Theralase does not have the financial capability of researching and running more trials than it is already doing.
As shareholders we all want to profit by our investment in Theralase. But more importantly, Theralase has the potential to treat many forms of cancer safely and effectively. It can't do this without help, but the kind of help needed is not going to come until it has been proven that pdt with TLD1433 is a safe and very effective treatment of BCG refractory NMIBC. And for that we have to wait until 2023. Meanwhile millions of people die of cancer every year. All we can do is wait and hope.
Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study Abdul-Amir Yassine, William C. Y. Lo, Tina Saeidi, Dallis Ferguson, Cari M. Whyne, Margarete K. Akens, Vaughn Betz & Lothar Lilge
Scientific Reports volume 11, Article number: 17871 (2021)
Abstract
Spinal metastases often occur in the advanced stages of breast, lung or prostate cancer, resulting in a significant impact on the patient’s quality of life. Current treatment modalities for spinal metastases include both systemic and localized treatments that aim to decrease pain, improve mobility and structural stability, and control tumour growth. With the development of non-toxic photosensitizer drugs, photodynamic therapy (PDT) has shown promise as a minimally invasive non-thermal alternative in oncology, including for spinal metastases. To apply PDT to spinal metastases, predictive algorithms that optimize tumour treatment and minimize the risk of spinal cord damage are needed to assess the feasibility of the treatment and encourage a broad acceptance of PDT in clinical trials. This work presents a framework for PDT modelling and planning, and simulates the feasibility of using a BPD-MA mediated PDT to treat bone metastases at two different wavelengths (690 nm and 565 nm). An open-source software for PDT planning, PDT-SPACE, is used to evaluate different configurations of light diffusers (cut-end and cylindrical) fibres with optimized power allocation in order to minimize the damage to spinal cord or maximize tumour destruction. The work is simulated on three CT images of metastatically involved vertebrae acquired from three patients with spinal metastases secondary to colorectal or lung cancer. Simulation results show that PDT at a 565 nm wavelength has the ability to treat 90% of the metastatic lesion with less than 17% damage to the spinal cord. However, the energy required, and hence treatment time, to achieve this outcome with the 565 nm is infeasible. The energy required and treatment time for the longer wavelength of 690 nm is feasible (∼40 min), but treatment aimed at 90% of the metastatic lesion would severely damage the proximal spinal cord. PDT-SPACE provides a simulation platform that can be used to optimize PDT delivery in the metastatic spine. While this work serves as a prospective methodology to analyze the feasibility of PDT for tumour ablation in the spine, preclinical studies in an animal model are ongoing to elucidate the spinal cord damage extent as a function of PDT dose, and the resulting short and long term functional impairments. These will be required before there can be any consideration of clinical trials.