Saturday, February 21, 2009

Primary clinical use of sonodynamic therapy (SDT) for advanced breast cancer

Sub-category: New Systemic Agents – Cytotoxics

Category: Treatment Meeting:

2008 Breast Cancer Symposium

Abstract No: 194

Author(s): T. J. Lewis, X. Wang


Background: Sonodynamic therapy (SDT), the synergistic effect of drugs and ultrasound, is promising for cancer treatment. A new sonosensitizing agent has been developed that is derived from chlorophyll, is sensitive to red light, and is extremely sensitive to ultrasound. This agent is specifically absorbed in tumor cells and produces cytotoxic moities upon interaction with 'diagnostic' ultrasound. Animal studies show that SDT inhibits growth of mouse S-180 sarcoma. Here we report clinical data for SDT for advanced breast cancer on 20 patients. Patients were considered late stage with metastasized carcinomas. Prior to SDT treatment, all patients had undergone convention therapies but received no benefit. Methods: All patients had pathologically proven breast carcinomas. The SDT agent was given to patients sublingually with a total dose of 30 to 60mg. After 24h, ultrasound was used to irradiate the general area of the tumors. Sound application was repeated one and two weeks later. Results: ~90% of patients treated experienced a positive response to SDT therapy. 35% experienced "excellent" responses with marked tumor elimination and alleviation of symptoms that was tracked for >1 year, eg. "Case 1." 30% experienced "good" responses also with tumor diminution and symptom relief, eg. "Case 2." Case 1 had left breast carcinoma with multi-organ metastases including auxiliary lymph nodes, bones, liver and abdomen lymph nodes. After 2 treatments PET/CT scan showed good PR. The latest PET/CT taken 28 months after the treatment showed no signs of tumor in any cavity of the body. Case 2 had breast carcinoma which spread broadly. The patient had surgery, chemo, RT, hormone, trastuzumab, zoledronic acid, etc, but all failed. The tumor kept growing until the patient had high-level paraplegia, breath failure, and heart failure. After 3 SDT treatments the patient's symptom improved significantly. Windpipe spile, gastric and urine catheter were all taken off. PET/CT scan showed a partial response. The patient died 7 months later. Conclusions: Primary clinical data shows that SDT is well tolerated and has a significant therapeutic effect for patients with advanced breast cancer. Terminally ill patient can be treated safely and effectively. Sonodynamic therapy has significant merit for further investigation.


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