In most cases, a diagnosis of skin cancer is not a life-threatening event. This is not the case, however, with malignant melanoma. This is by far the most aggressive and dangerous form of skin cancer. What makes malignant melanoma such a menace to modern oncology is its strong resistance to traditional chemotherapy and radiotherapy. These treatments are almost always ineffective against the disease.
Melanoma is a type of skin cancer that starts in the cells that make the pigment or coloring of the skin. These cells, called melanocytes, are found below the surface of the skin and produce a dark brown pigment called melanin. Melanocytes may grow rapidly and metastasize anywhere, though the most common sites for metastases are the liver, lung, bone, brain, and lymph nodes.
Given the lethal nature of malignant melanoma, it’s not surprising that so much research has focused on innovative ways to treat the disease. Among the innovations that has shown considerable promise is photodynamic therapy (PDT), a novel and effective treatment that may override some of the limitations of conventional treatments.
PDT has received a great deal of attention as a treatment for skin cancers in general, though most of this attention has focused on basal cell carcinoma. The basic approach involves the use of light-triggered chemical reactions between the photosensitizing agent, light (of a specific wavelength), and oxygen. The photosensitizer is a substance that absorbs and transmits light’s energy in order to destroy the cancerous cells.
Nano Attack on Malignant Melanoma
Many experimental PDT studies have indicated that that this treatment offers a promising way to treat advanced melanoma. Nevertheless, a number of challenges remain. The main problem is that most of the approved photosensitizing agents are not specific enough for melanoma, and some do not easily enter or penetrate the malignant cells.
To overcome this limitation, nanotechnology experts have developed new ways of delivering more of the photosensitizer into the cancer cells. Nanotechnology refers to the engineering of functional systems at the molecular scale or so-called nanoscale, which is a mere 1 to 100 nanometers. It refers to the science of working with atoms and molecules to build devices (such as robots) that are mind-bogglingly tiny.
In the realm of pharmacology—and by extension, photomedicine—nanotechnology research has led to the introduction of various nanoscale drug-delivery strategies such as liposomes, nanoemulsions, and antibodies (which target proteins on the outside of the tumor). Liposomes, for example, can readily pass through cell membranes and transport photosensitizers into cancer cells with greater efficiency. Such nanotechnology strategies may enhance the effectiveness of PDT, as reported in the September 2014 issue of Nano Reviews.
Tapping the Power of Bremachlorin-PDT
Another limitation with most of the approved photosensitizing agents is that they do not have the necessary versatility to attack the disease from multiple angles. The use of the agent Bremachlorin may offer an excellent option in this regard. Bremachlorin also overcomes the limitations mentioned above in terms of its ability to enter malignant cells easily and to be retained by those cells in contrast with normal healthy cells.
As documented in The Medicine of Light, the use of Bremachlorin-PDT (clinically approved in Russia as Radachlorin-PDT) has yielded excellent results when combined with surgery in malignant melanoma patients. Complete responses were reached in three out of four cases of patients with stage I and II melanomas who received Bremachlorin-PDT before surgery; the follow-up observation period for these patients ranged from nine to 12 months.
Compared to earlier-stage melanomas, patients with stage III and IV melanomas and skin involvement have very poor survival rates. Clinical observations in Russia have shown that laserthermia may have some promise against these more advanced melanomas. For example, laserthermia was successfully used to treat stage III melanoma of the soft palate along with metastases in the lymph nodes of the neck. This approach hass resulted in greatly improved survival when compared to conventional treatments for malignant melanoma.
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Kawczyk-Krupka A1, Bugaj AM, Latos W, Zaremba K, Sieroń A. Photodynamic therapy in treatment of cutaneous and choroidal melanoma. Photodiagnosis Photodyn Ther. 2013 Dec;10(4):503-9.
Monge-Fuentes V, Muehlmann LA, de Azevedo RB. Perspectives on the application of nanotechnology in photodynamic therapy for the treatment of melanoma. Nano Rev. 2014 Sep 1;5.. eCollection 2014.
Choromańska A, Saczko J, Kulbacka J, Skolucka N, Majkowski M. The potential role of photodynamic therapy in the treatment of malignant melanoma–an in vitro study. Adv Clin Exp Med. 2012 Mar-Apr;21(2):179-85.
Rundle P. Treatment of posterior uveal melanoma with multi-dose photodynamic therapy. Br J Ophthalmol. 2014 Jan 23. [Epub ahead of print] Rundle P. Treatment of posterior uveal melanoma with multi-dose photodynamic therapy. Br J Ophthalmol. 2014 Jan 23. [Epub ahead of print]
Kawczyk-Krupka A, Bugaj AM, Latos W, Zaremba K, Sieroń A. Photodynamic therapy in treatment of cutaneous and choroidal melanoma. Photodiagnosis Photodyn Ther. 2013 Dec;10(4):503-9.
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