European platform for photodynamic medicine: Why?

The celebration of the 21st birthday of the IPA in Shanghai is an opportunity for the European Platform for Photodynamic Medicine to announce its formation.

Clinical PDT has a problem of identify and recognition in many countries of the world. There are a number of reasons for this, not least being the fact that as a treatment method, PDT appears complicated to the clinician. It requires either a multi-disciplinary team or a dedicated practitioner who is au fait with all aspects of its application.

Since its inception the most important indication of PDT has been within the realm of oncology. It is, essentially, a local therapy and as such has great attraction to surgeons such as myself and also to interventional physicians. It is relevant to recall that the first bronchoscopic PDT for lung cancer was carried out by surgeons at Tokyo Medical University [1], [2]. It is, however, a sad fact that 25 years after this groundbreaking work many oncologists and specialists in respiratory medicine are neither familiar with the potentials of PDT nor consider it as a treatment option in lung cancer. Rather, they cling desperately to the traditional trio of surgery, radiotherapy and chemotherapy playing unharmoniously the variation on the theme of “plus ça change plus c’est la même chose.”

Europe has been seminal in the science of PDT [3]. It has not, however, risen to the challenge of applying the science in a clinical setting. Although much is happening on the laboratory bench, little of this scientific effort has been translated into patient treatment. In short, we seem to be stuck in the field of “Photodynamische Wirkung” as opposed to moving into Photodynamic Therapy except in widely separated areas of clinical specialities.

Whilst acknowledging the value and undoubted effort of National and European Laser and Photobiology associations in incorporating PDT within their scientific meetings, the fact remains that a clinician specialist who uses PDT does not have a dedicated forum which will foster and nurture his clinical interest. The time has come to draw together the islands of clinical interest in Photodynamic Medicine in Europe into a cohesive unit. Such a group will comprise all components, which can drive forward PDT as a treatment option. In forming such an association it is important to consider the place of industry. There is no disagreement that any organisation with PDT at its heart needs to be based on the principal of partnership between clinician and scientist. There should equally, be no dispute regarding the inclusion of the relevant industries within such an organisation. The tradition, which regards industrial companies as a bottomless repository, which will disperse funds for research and clinical trials, has proved to be unrealistic in the case of PDT. This industry is still in a developmental stage and per se, too small within the greater world of industry to individually withstand the pressure of supporting continuing research and development as well as clinical trials, the latter an essential ingredient in the application of PDT to patients. With this in mind the European Platform recognises the need for industry to have a voice within the chorus of the ensemble of European PDT.

The meeting in Shanghai is an occasion to congratulate the founders of the IPA who will witness so many scientists and clinicians joining together in a common cause. As a prelude to the Shanghai meeting this journal has published, in two recent issues, the history of PDT in China. This has been expertly documented by Dr. Zheng Huang [4], [5]. Also, to coincide with the Shanghai meeting the current issue of PDPDT contains five articles by Chinese authors involved in Photodiagnosis and Photodynamic Therapy.

For the future, PDT can only survive if the various constituent parts: clinical, scientific, industrial can co-operate to expand the boundaries with the ethos of patient benefit firmly at the centre.