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Laser-excited gold nanoparticles safely destroyed prostate tumors in a recent pilot study involving 16 patients with low- to intermediate-risk prostate cancer. The highly targeted approach is being developed as an alternative to prostatectomy and radiation therapy, treatments associated with adverse urinary and sexual effects.
The technique, described in the Proceedings of the National Academy of Sciences, takes advantage of tiny holes in tumor blood vessels. A day before an ablation procedure, gold-coated silica nanoshells 50 times smaller than a red blood cell are infused into a patient’s bloodstream. The particles preferentially accumulate in the tumors, gaining access through leaky blood vessels. The next day, lasers are beamed through needles inserted into the lesion. Set to a specific near-infrared wavelength, the lasers excite the nanoshells, heating them up.
In the recent study, the heated particles killed prostate tumors without destroying nearby tissue. No serious adverse events were reported at 3 months, the primary safety end point, and there were no significant changes in prostate or sexual health symptoms. One patient experienced an adverse reaction to the infusion fluid temperature and did not undergo ablation.
Although the pilot trial was too small to determine efficacy, the results were promising: in 13 patients, the ablation zones were cancer free a year after the procedure. The 2 treatment failures were likely due to underestimation of tumor volume.
Three-month results from the full cohort of 45 patients will be published early next year. The cohort will also be incorporated into a larger multi-institutional study.
Because many tumor types have leaky blood vessels, the approach could have broad oncology applications, according to the study’s principal investigator Ardeshir Rastinehad, DO, of the Icahn School of Medicine at Mount Sinai in New York City.
Abbasi J. Gold Nanoshells Ablate Prostate Tumors. JAMA. 2019;322(14):1343. doi:10.1001/jama.2019.15868
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