Patient Guide

PDT: Step by Step

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

PDT with PHOTOFRIN® is approved to treat non-small-cell lung cancer (a type of lung cancer) in patients for whom usual treatments are not appropriate and to relieve symptoms in patients in whom the cancer obstructs the airway, or in which the cancer cells slightly invade surrounding tissues. PHOTOFRIN® is also approved to relieve symptoms of esophageal (food pipe) cancer when the cancer blocks the esophagus or when the cancer cannot be treated with laser alone.1

This 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 photosensitivity (an abnormally strong sunburn-like reaction when exposing the skin to sunlight or bright indoor light), a potential side effect in anyone undergoing PDT.1

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

About PHOTOFRIN^®
Before Treatment
During Treatment
After Treatment
Other Common Side Effects
Other Possible Side Effects
FAQs

Reference: 1. PHOTOFRIN^® (porfimer sodium) Injection US Prescribing Information, August 2008.

Important Safety Information

Contraindications

PHOTOFRIN^® is contraindicated in patients with porphyria
Photodynamic therapy (PDT) is contraindicated in patients with an existing tracheoesophageal or bronchoesophageal fistula
PDT is contraindicated in patients with tumors eroding into a major blood vessel
PDT is not suitable for emergency treatment of patients with severe acute respiratory distress caused by an obstructing endobronchial lesion because 40 to 50 hours are required between injection with PHOTOFRIN^® and laser light treatment
PDT is not suitable for patients with esophagealor gastricvarices, or patients with esophagealulcers >1 cm in diameter

Warnings and Precautions

Do not initiate PHOTOFRIN^® with PDT in patients with esophageal tumors eroding into the trachea or bronchial tree or bronchial wall because of the high likelihood of tracheoesophageal or bronchoesophageal fistula
Gastrointestinal perforation can occur
High risk of bleeding in patients with esophageal varices
High risk for fatal massive hemoptysis with endobronchial tumors that are large, centrally located; cavitating; extensive, extrinsic to the bronchus
All patients who receive PHOTOFRIN^® will be photosensitive and must observe precautions to avoid exposure of skin and eyes to direct sunlight or bright indoor light for at least 30 days. Ocular sensitivity is also possible; instruct patients when out doors to edema, bronchostenosis wear dark sunglasses. See full Prescribing Information
Allow 2-4 weeks between PDT and subsequent radiotherapy• Substernalchestpainmayoccuraftertreatmentbecause of inflammatory responses within the area of treatment
Treatment-induced inflammation can cause airway obstruction. Administer with caution to patients with tumors in locations where treatment-induced inflammation can obstruct the main airway
Patients with hepatic or renal impairment may need longer precautionary measures for photosensitivity• Thromboembolic events can occur following photodynamic therapy with PHOTOFRIN^®

Adverse Reaction Profile

Most toxicities associated with PHOTOFRIN^® therapy are local effects seen in the area of illumination and occasionally in surrounding tissues and are characteristic of an inflammatory response
All patients who receive PHOTOFRIN^® will be photosensitive and must observe precautions listed in the Prescribing Information
Photosensitivity reactions occurred in approximately 20% of cancer patients treated with PHOTOFRIN^® in clinical studies
Typically these reactions were mostly mild to moderate erythema but they also included swelling, pruritus, burning sensation, feeling hot, or blisters. In a single study of 24 healthy subjects, some evidence of photosensitivity reactions occurred in all subjects
Other less common skin manifestations were also reported in areas where photosensitivity reactions had occurred, such as increased hair growth, skin discoloration, skin nodules, increased wrinkles and increased skin fragility. These manifestations may be attributable to a pseudoporphyria state (temporary drug-induced cutaneous porphyria)
Conventional ultraviolet (UV) sunscreens will only protect against UV light-related photosensitivity and will be of no value in protecting against induced photosensitivity reactions caused by visible light

Most Common Adverse Reactions

The following adverse reactions were reported in >10% of patients:

Esophageal Cancer: Anemia, pleuraleffusion, pyrexia, constipation, nausea, chestpain, pain, abdominal pain, dyspnoea, photosensitivity reaction, pneumonia, vomiting, insomnia, back pain, pharyngitis
Obstructing Endobronchial Cancer: Dyspnea, photosensitivity reaction, hemoptysis, pyrexia, cough, pneumonia
Superficial Endobronchial Tumors: Exudate, photosensitivity reaction, bronchial obstruction, edema, bronchostenosis