Remediating Desmoplasia using Targeted Photo-nanomedicines: Improving Surgical and Survival Outcomes

In recent years, a deeper understanding of the sub-therapeutic photodynamic priming (PDP) effects of photodynamic therapy is being gained. Here we show that PDP can remediate desmoplasia in pancreatic and head and neck tumors, improving both surgical and survival outcomes. Orthotopic FaDu head and neck tumors and MIA-PaCa-2 pancreatic tumors were used. PDP is facilitated by various nanoconstructs containing benzoporphyrin derivative and its lipidated variants, in addition to molecular targeting provided by conjugates of Cetuximab (anti-EGFR monoclonal antibody). PDP improved the tumor delivery and diagnostic accuracy of the clinical fluorescence image-guided surgery probe Cetuximab-IRDye800CW by 264.2%. Time-to-surgery is reduced from 25.7 h to 2.5 h. PDP also reduced the density (>90%) and alignment (>103-fold) of collagen in pancreatic tumors. PDP induced 90% tumor growth inhibition at 8.1% of the clinical chemotherapy dose and doubled overall survival. This study demonstrates how remediating desmoplasia using PDP plays a versatile role in cancer management, from improving image guided surgery to potentiating chemotherapy.