Photodynamic therapy (PDT) is a treatment for certain kinds of cancer that combines a drug, called a photosensitizing agent PHOTOFRIN®, with a specific type of light to kill cancer cells.

Endobronchial Cancer
PHOTOFRIN® is indicated for the treatment of microinvasive endobronchial non-small-cell lung cancer (NSCLC) in patients for whom surgery and radiation therapy, a process that uses certain energy waves to kill cancer cells, are not indicated. PHOTOFRIN® is indicated for the reduction of blockage and symptom relief in patients with lung cancer of a certain type (NSCLC) that partially or totally blocks the bronchi (airways entering the lungs).¹

PDT with PHOTOFRIN® is approved to treat airway blockage in a certain type of non-small cell lung cancer (NSCLC) in patients for whom surgery and radiotherapy are not appropriate. PDT with PHOTOFRIN® is used to relieve symptoms in patients with endobronchial NSCLC when the cancer obstructs or blocks the airway.

Esophageal Cancer
PHOTOFRIN® is indicated to help lessen symptoms of esophageal (food pipe) cancer when the cancer blocks the esophagus or when the cancer cannot be treated with laser alone.

High-Grade Dysplasia in Barrett’s Esophagus
PHOTOFRIN® is indicated for the ablation of high-grade dysplasia in Barrett’s esophagus (precancerous conditions) patients who do not have part or all of the esophagus removed with surgery.

Patient Guide
The patient guide has been designed to help you understand how PDT with PHOTOFRIN® works and what side effects may occur. It also explains what you need to do before and after treatment to prevent complications due to a light sensitivity reaction, which is an abnormally strong sunburn-like reaction when your skin is exposed to sunlight or bright indoor light. PHOTOFRIN® makes all patients sensitive to light. Light sensitivity reaction is a common side effect for people who are treated with PDT.

If, after reading this guide, you have further questions, be sure to discuss them with your healthcare professional.

IMPORTANT SAFETY INFORMATION AND INDICATION

Do not take PHOTOFRIN® (porfimer sodium) for injection:

• If you have a rare disorder with a blood component called porphyria
• If you have an abnormal connection (fistula) between the esophagus and airways leading to the lungs
• If you have a tumor extending into a major blood vessel
• If you have life-threatening breathing failure due to an obstructing airway tumor that requires emergency treatment
• If you have enlarged veins in the stomach or esophagus or large ulcers in the esophagus

What should I tell my healthcare provider before taking PHOTOFRIN®?

Before taking PHOTOFRIN®, tell your healthcare provider about all your medical conditions, including if you are:

• Taking other medicines that are activated by light
• Taking other medicines during your photodynamic treatment with PHOTOFRIN®
• If you are pregnant or are a nursing mother

What is the most important information I should know about PHOTOFRIN®?

• Sensitivity or allergic reaction to light should be expected; eye sensitivity is possible. This reaction is called phototoxicity, which has a sunburn-like effect and may be severe. All patients receiving PHOTOFRIN® will be sensitive to light and must take precautions to avoid exposure of eyes and skin to direct sunlight or bright indoor light for at least 30 days, but it may be required for more than 90 days. The phototoxicity with PHOTOFRIN® is unique since it is activated, not only by UV light, but also by light visible to your eyes that is usually safe for humans. Phototoxicity reactions with PHOTOFRIN® can occur following the first exposure to direct sunlight or intense indoor light from within a few minutes to up to several hours after exposure; resulting skin damage can persist. After PHOTOFRIN® administration, when outside wear protective clothing and dark sunglasses which let less than 4% white light through.
• An abnormal connection (fistula) can occur if an esophageal tumor is eroding into the main airway leading to the lungs or into one of its branches
• Holes can develop through the wall of the organs in your digestive system where photodynamic therapy was applied (esophagus, stomach, small intestine, large bowel, rectum, gallbladder)
• Bleeding can occur if you have enlarged veins in your esophagus
• Some patients with treated lung cancer lesions are at high risk for coughing up life-threatening amounts of blood
• If you are being treated for pre-cancerous cells (high-grade dysplasia) in Barrett’s esophagus, biopsy of your esophagus will be performed every 3 months and checked by your doctor until 4 consecutive biopsies are negative for high-grade dysplasia
• If you require radiotherapy after treatment with PHOTOFRIN®, the radiotherapy should not be started until 2-4 weeks after your PHOTOFRIN® treatment
• You may experience chest pain or breathing difficulty. Notify your doctor if you experience chest pain or any other side effects after treatment with PHOTOFRIN®. Your doctor may prescribe medication to help reduce the pain.
• Photodynamic therapy for advanced lung cancer may block the main lung airway, leading to life-threatening difficulty breathing
• Narrowing of the esophagus occurs frequently after treatment of pre-cancerous cells (high-grade dysplasia) in Barrett’s esophagus
• If you have liver or kidney problems you may be need to take extra precautions regarding sensitivity to light and for a longer time period
• Blockage of blood vessels from pieces of a blood clot can happen after treatment with PHOTOFRIN®
• Embryo-Fetal Toxicity: May cause embryo-fetal toxicity. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception.

What are the possible side effects of PHOTOFRIN®?

Sensitivity to light will occur in all patients. Allergic reaction to light may occur in all of the following indications:

• For esophageal cancer (treatment of the esophagus): anemia, accumulation of fluid in the lungs, fever, constipation, nausea, chest pain, general pain, stomach pain, difficulty breathing, pneumonia (infection of the lung), vomiting, difficulty sleeping, back pain, inflammation of the throat
• For obstructing endobronchial cancer (when cancer blocks the lungs airways): difficulty breathing, coughing with or without small amounts of blood, fever, coughing, pneumonia (infection of the lungs)
• For superficial endobronchial tumors (when cancer slightly invades surrounding tissues): fluid leaking out of blood vessels into nearby tissue,  blockage of lung airways, swelling of tissue due to large fluid volume, narrowing of the main airway leading to lungs
• High-grade dysplasia (pre-cancerous cells) in Barrett’s Esophagus (treatment of the esophagus): narrowing of the esophagus, vomiting, chest pain, nausea, fever, constipation, difficulty or pain when swallowing, abdominal pain, accumulation of fluid in the lungs, dehydration

These are not all the possible side effects of PHOTOFRIN®. For more information call your healthcare provider. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088 or call Pinnacle Biologics, Inc. at 1-866-248-2039.

Indication

PHOTOFRIN® is used for:

• Relieving symptoms of esophageal cancer when the cancer blocks the esophagus or when the cancer cannot be treated by laser alone.
• Treating non-small-cell lung cancer that slightly invades surrounding tissues when the other usual treatments are not appropriate
• Relieving symptoms and reducing obstruction of non-small-cell lung cancer in patients in whom the cancer blocks the lung airways
• Removal of abnormal, pre-cancerous cells (high-grade dysplasia) in Barrett’s esophagus when there is no removal of the esophagus by surgery

Please see Full Prescribing Information.

Reference: 1. PHOTOFRIN® (porfimer sodium for injection) [package insert]. Bannockburn, IL: Pinnacle Biologics.