Talaporfin Sodium

The long-term local control and effect of photodynamic therapy (PDT) using talaporfin sodium and a diode laser (talaporfin PDT) on overall survival (OS) for local failure after chemoradiotherapy (CRT) for esophageal cancer are unknown. Here, we present a 5-year survival analysis for talaporfin PDT.

This was a prospective follow-up analysis of an open-label, multicenter, phase 2 study of local failure after CRT or radiotherapy in patients who received talaporfin PDT. The primary endpoint was the overall OS. The secondary endpoints were progression-free survival (PFS), local progression-free survival (L-PFS) with local progression or recurrence and death as events, and local time to progression (L-TTP) with only local progression or recurrence as events.

Between November 2012 and December 2013, 26 patients with oesophageal squamous cell carcinoma underwent talaporfin PDT. The baseline T stages were cT1 in 14 patients, cT2 in 6 patients, and cT3 in 6 patients. Pre-PDT T stages were cT1b for 19 and cT2 for 7 patients, and no lymph nodes or distant metastases were detected. At a median 6.8-year follow-up, the median OS and 5-year OS rates were 4.2 years (95% confidence interval [CI]: 1.6–7.3) and 40.6% (95% CI: 21.7–58.7), respectively. The median PFS and L-PFS were 1.1 and 2.1 years, respectively. The 5-year local progression-free rate was 84.9%. No treatment-related deaths occurred.

Talaporfin PDT for patients with oesophageal cancer with local failure after CRT can achieve long-term local complete response and long-term survival as a minimally invasive salvage treatment.

UMIN000009184.

Salvage endoscopic therapy is increasingly recommended for localized, superficial failure at the primary site after chemoradiotherapy for esophageal squamous cell carcinoma. This multicenter retrospective study aimed to evaluate the clinical outcomes and prognostic factors associated with overall survival in patients who underwent salvage endoscopic therapy for cT1N0M0 local failure after chemoradiotherapy or radiotherapy for esophageal squamous cell carcinoma.

We retrospectively analyzed patients with cT1N0M0 local failure after chemoradiotherapy or radiotherapy who underwent endoscopic resection or photodynamic therapy using talaporfin sodium at two Japanese institutions between 2012 and 2021. Clinical outcomes and prognostic factors for overall survival were assessed using multivariate analysis.

Complete resection was achieved in 63 of 84 patients (75%) who underwent endoscopic resection, and a local complete response was achieved in 50 of 81 patients (62%) who underwent photodynamic therapy. During a median follow‐up of 34 months (range, 2–109 months), 3‐year overall survival, disease‐specific survival, local recurrence‐free survival, and esophagectomy‐free survival rates were 79%, 88%, 54%, and 79%, respectively. A high Charlson Comorbidity Index (≥ 3; hazard ratio: 3.3) was significantly associated with poor overall survival (3‐year overall survival rate: 64%), although the 3‐year disease‐specific survival in this group remained high at 94%.

We clarified the clinical outcomes and prognosis of salvage endoscopic therapy for cT1 local failure. The Charlson Comorbidity Index may serve as a useful prognostic factor to aid in clinical decision‐making.