Photoimmunotherapy (using a
monoclonal antibody-targeted
photosensitizer and red light) may be a strategy to overcome the limitations inherent in
photodynamic therapy of liver
tumors. The aims of this study were (a) to test the efficacy of selective treatment of hepatic
metastases of
colorectal cancer in an orthotopic murine xenograft using the murine
monoclonal antibody 17.1A conjugated to the
photosensitizer chlorin(e6), and (b) to compare the
tumor response after the same light dose was delivered at two different fluence rates. Based on previous biodistribution studies that had shown that the photoimmunoconjugate with a polyanionic charge had both a higher absolute
tumor chlorin(e6) content and a greater
tumor:normal liver ratio than those obtained with a photoimmunoconjugate bearing a polycationic charge, mice were treated 3 h after i.v. injection of the polyanionic 17.1A
chlorin(e6) conjugate or unconjugated
photosensitizer. Red light was delivered into the liver
tumor by an interstitial fiber, and
tumor response end points were total
tumor weight in the short term and survival in the long term. There was a highly significant reduction (<20% of controls; P = 0.0035) in the weight of the
tumors in the mice treated with photoimmunotherapy, and the median survival increased from 62.5 to 102 days (P = 0.015).
Photodynamic therapy with free
chlorin(e6) produced a smaller decrease in
tumor weight and a smaller extension of survival, neither of which were statistically significant. A comparison of photoimmunotherapy with 10 J of light delivered at 30 or 300 mW showed that the higher fluence rate prolonged survival significantly more than the lower fluence rate. This may have been because the high fluence rate gave a contribution of
laser-
induced hyperthermia to the photodamage. Correlation studies showed that the amount of normal liver remaining at necropsy correlated best with survival. Photoimmunotherapy shows efficacy in destroying liver
tumors, and future studies should maximize selectivity to minimize the destruction of normal liver.