Professor of Dermatology, Harvard Medical School
Phone: 617-726-6856
Fax: 617-726-8566
E-mail: thasan@partners.org
Complete curriculum vitae is available in text format.
The goal of this Program is an integrated approach to the optimization of photodynamic therapy (PDT). The Program has a translational approach and encompasses elements of PDT from basic research in cellular mechanisms through treatment of appropriate animal models of cancer and sophisticated apparatus for feedback dosimetry, to a clinical trial for Barrett's esophagus: it is truly a "bench-to-bedside" proposal. We will concentrate on three broad areas of research: modulation of the target tissue with the aim of increasing the tumor sensitivity and selectivity of the treatment, determination of methods of optimizing local control of tumors without increasing the risk of distant metastasis, and dosimetric tools with the potential for real-time on-line measurement of critical parameters. There are clinical components comprising trials to treat Barrett's esophagus and psoriasis with a combination of differentiation therapy and PDT. Hence the Program will encompass the translation of basic science to human therapeutic studies and contains an integrated approach to PDT covering broad areas of research starting from the basic science involved in studying cellular differentiation and transcription factors to the selection of appropriate animal models for studying metastasis, to technological advances in modern dosimetric tools, and ending with a clinical trial that aims to help patients suffering from a distressing and potentially life-threatening disease.
Project 4 addresses the relationship between PDT and distant metastasis, a consequence that may not surface for years after the primary treatment. The motivations for such a study are: (a) A number of interventional treatments of prostate cancer (PCa), which involve physical manipulations similar to those involved in PDT, are believed to encourage metastatic colonization, presumably by shedding of tumor cells. PDT may logically be considered an attractive option for the treatment of advanced localized prostate cancer and indeed has very recently received FDA approval for Phase I clinical trials. It is important to establish what, if any, the effects of PDT might be on metastasis. (b) Surprisingly little is known about this aspect of PDT. Our studies with BPD as the PS in an orthotopic rat PCa model and the orthotopic model observed an increase in distant metastasis following PDT. Recently, we were able to confirm these data in a human PCa implanted in SCID mice. There are many factors that determine metastatic colonization following interventional treatment including (but not limited to) the induction of hypoxia, loss or induction of cellular receptors, loss of intercellular and cell-extracellular matrix (ECM) adhesion, vascular damage caused by PDT and differentiation status of tumor. It is the aim of Project 4 to establish which aspects of PDT response, if any exacerbate or inhibit metastasis. Techniques and information gathered in Projects 1-3 such as the effect of differentiation, extent of hypoxia and optimal dosimetry, will be used for elucidating factors affecting PDT control of metastasis.
Photodynamic therapy (PDT) is a process in which a light-responsive chemical, when exposed to the appropriate wavelength of light, is activated to undergo either a photophysical process or to initiate photochemistry, producing molecular species which can interact with biological targets (photosensitization). Such interactions can be exploited for biomedical applications or for basic studies. The three major aspects of photoactivation that our laboratory is engaged in are:
Photosensitization is exploited for the destruction of tumors and certain non-neoplastic target tissues in an approach termed photodynamic therapy (PDT). Compounds, typically porphyrins, are localized in target cells and tissues and upon light activation cause destruction at sites of localization. An advantage of this approach is that it minimizes normal tissue damage due to the dual selectivity inherent in the technique. (i) Preferential localization of the photosensitizer, (ii) spatial localization of the activating light. The more specific the localization of the photosensitizer, the more efficient and selective the response.
Two of our goals in the PDT area are:
In synthetic studies, photosensitization is being used as a tool for the preparation of biologically useful molecules e.g. using photoaffinity labeling to synthesize and characterize nucleotide binding sites on monoclonal antibodies where the nucleotide has been linked to peptides and photosensitizers.
In mechanistic studies, the biological consequences of PDT at the animal, cellular and molecular levels are being investigated. For example, the photodynamic destruction of primary prostate cancer in an orthotopic rat tumor model shows good local control, but an increase in lung metastasis. Based on initial studies our current hypothesis is that there are two major factors responsible for this increase in metastatic spread. PDT-induced transient decrease in cellular adhesion to ECM via specific integrins and the high expression of vascular endothelium growth factor (VEGF) in the normal prostate tissue. (c) Another mechanistic project uses targeted photosensitization to clarify the role of growth factors and of subcutaneous fibroblasts in wound repair.