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Fapesp supports innovative research on skin cancer treatment

Study is conducted by scientists Institute of Physics of São Carlos, USP; procedure is under evaluation

A technique created at the Center for Research in Optics and Photonics (CEPOF), one of the Centers for Research, Innovation and Dissemination (CEPIDs) supported by the Foundation for Research Support of the State of São Paulo (Fapesp), may represent advances in the fight against cancer of skin.

The analyzes were presented during the São Paulo School of Advanced Science in Modern Topics in Biophotonics. Supported by Fapesp, in the São Paulo School of Advanced Science modality, the event was held at the end of March at the São Carlos Institute of Physics , University of São Paulo (IFSC-USP).

In recent years, a group of local researchers have developed a device for the diagnosis and optical treatment of non-melanoma skin cancer with promising results, especially in the elimination of early tumors. The procedure is being evaluated to be implemented in the Unified Health System (SUS).

Treatment

Patients with non-melanoma skin cancer may soon have a new technology for the noninvasive treatment of this type of cutaneous tumor, the most frequent in Brazil and worldwide.

The meeting brought together postgraduate students and young researchers from Brazil and abroad to discuss advanced topics in the field of biophotonics, using technologies based on the manipulation of photons, that is, light, for biological applications.

"The device was developed in Brazil, with totally national technology," explained Cristina Kurachi, a professor at the IFSC-USP and one of the authors of the technique. The equipment, manufactured by MM Optics in São Carlos, is composed of a device capable of recognizing and verifying the extent of tumor lesions by optical fluorescence in minutes.

Procedures

After identification of the lesion, an ointment based on methylaminolevulinate (MAL) - a derivative of 5-aminolevulinic acid (ALA) - developed by the company PDF-Pharma in Cravinhos is applied.

After two hours of contact with the skin, the compound is absorbed and gives rise to protoporphyrin, a "prime" photosensitizing pigment of chlorophyll within the tumor cell mitochondria.

After removing the ointment from the lesion, the region is irradiated for 20 minutes with a device containing a 630-nanometer red LED light source integrated into the device. The light activates the protoporphyrin and triggers a series of reactions in the tumor cells, generating reactive species of oxygen able to eliminate the lesions. Already the healthy tissues are preserved.

Following the procedure, fluorescence images are generated, also by means of the equipment, to ensure total irradiation of the lesions. The treatment takes place in two sessions, with interval of one week between them. After 30 days, the lesions are reassessed and biopsied to confirm if the tumors have been cleared.

Essay

Through a project supported by the National Bank of Economic and Social Development (BNDES) and the Financier of Innovation and Research (Finep), clinical trials were carried out to validate the technique in 72 health centers throughout the country. The multicenter study was coordinated by Vanderlei Salvador Bagnato, professor at the IFSC-USP and coordinator of CEPOF.

At the Hospital Amaral Carvalho de Jaú, in the interior of São Paulo, for example, more than 2,000 patients were treated with the new method and 40 groups of physicians were trained to use the technique. In addition to hospitals, clinics and clinics in Brazil, clinical studies were conducted in nine other Latin American countries.

The results of the clinical trials showed that the treatment was able to eliminate 95% of the tumors without side effects, causing only slight redness at the site and without scar formation.

Conference

Postdoctoral fellow in chemical biology at the University of Cape Town, South Africa, where he studies the application of photodynamic therapy to treat skin cancer, researcher Fleury Augustin Nsole Biteghe learned of the event by attending a conference on photodynamic therapy last year , in Germany, where some results of work done by the researchers of the IFSC-USP were presented.

"I was impressed and very interested in being part of this group's research in Brazil, which has shown that it is possible to do translational research that results in new treatments for skin cancer," he said.

"I intend to apply for a postdoctoral fellow in this research group to learn and take this experience to South Africa, where we have faced obstacles to develop technologies that make it possible to use photodynamic therapy in clinical practice," Biteghe said.

The School brought together 138 postgraduate students and early-stage researchers, of whom 48 were from abroad (from countries such as the United States, Finland, Norway, Russia, Poland, Canada and Argentina, among others) and 90 Brazilians, regions of Brazil.

The program was organized by scientific posters, lectures and courses given by some of the greatest specialists in areas such as tissue optics, neurophotonics and biosensors.