Photoimmunotherapy for head and neck cancer

Abstract

The treatment is based on the antibody-photosensitive substance complex AKALUX® and light irradiation. The dye is activated by 690-nm light irradiation 20–28 h after administration of AKALUX®, and it is expected to induce a rapid cell-killing effect only to cells to which the complex has bound, where there is selective destruction of cancer cells only. Furthermore, it is expected to minimize damage to normal tissues surrounding tumor cells. In Japan, it has been approved for the treatment of unresectable locally advanced or locally recurrent head and neck cancer and has been covered by the National Health Insurance System since January 1, 2021.

Treatment is considered for unresectable locally advanced or locally recurrent head and neck cancer. When standard treatments such as chemoradiotherapy are available, these treatments are given priority.

Drugs are administered during the patient’s hospitalization. Light exposure protection is required during and after administration. Premedication should include intravenous corticosteroids and antihistamines followed by intravenous AKALUX® infusion over at least 2 h; 20–28 h after completion of AKALUX® administration, light irradiation is performed for 4–6 min under general anesthesia. Depending on the size of the lesion, multiple sessions may be performed.

Light exposure protection should be taken for 4 weeks, postoperatively. Moreover, bleeding, tongue swelling, laryngeal edema, and skin lesions, among others, should be observed. If a complete response is not achieved, the treatment may be repeated up to four times.