TOOKAD vascular-targeted photodynamic therapy (VTP)

Vascular-targeted photodynamic therapy uses an intravenous photosensitiser that is activated by transperineal laser light. The aim is to damage tumour microvasculature in a planned zone of the prostate while limiting thermal injury beyond that region.

Mechanism in brief

After the drug distributes, low-power laser fibres are placed to illuminate the target volume. The photochemical reaction produces local ischaemia and cell death pathways that differ from simple heat-based ablation, though some heating may still occur at fibre tips.

Evidence base

Randomised trial data in localised low-risk prostate cancer helped define initial regulatory indications in some jurisdictions. Longer follow-up, retreatment rules and comparison with active surveillance or radical treatments continue to evolve in the literature.

Practical considerations

  • Photosensitivity precautions after infusion are mandatory until cleared by protocol.
  • Urinary catheter duration and infection prevention depend on unit policy.
  • Not all patients meet imaging or risk criteria used in published trials.
Drug names, laser devices and PBS or funding status change over time. Confirm local availability with your treating team.
References
  1. Azzouzi AR, Barret E, Bennet J, et al. - PADT-01-001 Investigators. TOOKAD Soluble vascular-targeted photodynamic therapy versus active surveillance in men with low-risk prostate cancer (CLIN1001 PCM301): an open-label, phase 3, randomised controlled trial. Lancet Oncol. 2017 Feb;18(2):181-191 - doi: 10.1016/S1470-2045(16)30661-1
  2. John R Heard, Aurash Naser-Tavakolian, Michael Nazmifar - Focal prostate cancer therapy in the era of multiparametric MRI: a review of options and outcomes - Prostate Cancer Prostatic Dis. 2023 Jun;26(2):218-227 - DOI: 10.1038/s41391-022-00501-0
  3. Emberton M, Anson K, Briggs A, et al. - A multicenter, randomized, double-blind, placebo-controlled trial evaluating padeliporfin vascular-targeted photodynamic therapy versus placebo in men with low-risk prostate cancer (CLIN1001 PCM301). J Urol. 2018 Jan;199(1):79-87 - doi: 10.1016/j.juro.2017.08.010

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