Vascular targeted photodynamic therapy in low-risk prostate cancer. A literature review

Introduction. - Currently, about 50% of newly prostate cancers are localized and low-risk according to D'Amico risk classification. Focal therapies whose objective is to treat only the index lesion appear as a new alternative being evaluated in the management of these cancers. Besides the interest in the control of the disease, focal therapies present a very low risk of morbidity. Vascular targeted photodynamic therapy (VTP) is one of these new emerging therapies. Method. - An exhaustive review concerning VTP in prostate cancer was carried out. A search by the following keywords ``low-risk prostate cancer'', ``focal treatment'', ``vascular targeted photodynamic therapy'' ``TOOKAD'' was carried out in Pubmed and Embase. Results. - In phase II studies, VTP showed a rate of 80% negative biopsies at 6 months, with good clinical tolerance. The European phase III, randomized prospective study, comparing VTP to active surveillance showed a lower proportion of progression, as well as a more significant duration before progression for VTP. The adverse events are mostly moderate and transient. The quality of life of patients is preserved, with a moderate impact on erectile and urinary functions. Conclusion. - VTP appear to be a promising new approach in localized low-risk prostate cancer. (C) 2019 Elsevier Masson SAS. All rights reserved.