“Tumor treatment is a worldwide problem.” Recently, Zeng Jun, executive director of Wuxi Yiren Cancer Hospital, said that with the change of survival environment, malignant tumor has become one of the main causes of death of our residents. In view of this, as early as more than ten years ago, China began to pay attention to various industrial chains in the field of tumor treatment and invested a lot of human, material and financial resources in order to achieve the purpose of being able to control, or even cure, tumors. “Most of the traditional programs of tumor treatment are still ‘headache treatment, foot pain treatment’, and so far a method similar to the therapeutic effect of ‘penicillin’ has not been found.” The so-called “penicillin” effect is mainly summarized from its efficacy, because penicillin, as a highly effective, low toxicity, widely used antibiotic, has the advantage of not targeting a certain disease, but a certain type of disease. Inspired by the “one-to-many” treatment mode of penicillin, Zeng Jun began to think: for tumor treatment, can we develop a method similar to the “penicillin” treatment effect, so as to solve the problems faced by most of the tumor patients. So, driven by his dream and responsibility, and inspired by the biological properties and energy conversion characteristics of porphyrins, Zeng Jun led his team to start a long trek in the field of tumor therapy. Hardware for guarantee Positron Emission Computed Tomography PET is one of the most advanced medical imaging techniques for imaging human function and metabolism at the cellular molecular level. It can quantitatively and dynamically detect changes in metabolic substances or drugs in the human body from outside the body, making it the best method for diagnosing and guiding the treatment of various malignant tumors, coronary heart disease and brain diseases. And MR is likewise an advanced magnetic resonance imaging technique. The combination of PET/MR, in Zeng Jun’s opinion, can achieve the effect of “1+1>2”. The “penicillin” model If the advanced medical equipment is not transformed into actual productivity and served in the clinic, it is just like a vase, which is “not useful”. The direction of modern medicine is the organic combination of personalized medicine and molecular targeting medicine, but the physical characteristics of traditional rays do not meet the needs of personalization and biological targeting. Traditional radiation mainly produces hydroxyl radicals through ionization of water in cells, which in turn kills and destroys cells, but the problem with this treatment mode is that water is uniformly distributed in cells, and the hydroxyl radicals produced after ionization are also uniformly distributed in cells, which does not have biomolecular targeting effect. At the same time, hydroxyl radicals traverse a very short distance in the cell, and most of them disappear before they reach the biomolecules, and very few of them play an effective role. “Then again, normal cells also contain a lot of water and are rich in oxygen, and the rays have equal killing power on normal cells with very obvious side effects.” Zeng Jun said that conventional radiation therapy does not achieve clinically satisfactory results. And traditional chemotherapy is based on cytotoxic effect, also does not have a molecular targeting effect, and in the tissue cell distribution, but also lack of specificity and affinity, the treatment effect is also unsatisfactory. So, how to use high-energy photons can achieve molecular targeting therapy? First of all, we should choose a substance that is excited by high-energy photons, and this substance should have both non-toxicity and good molecular targeting distribution, and after being excited, it can also convert physical energy into chemical energy and form single linear state oxygen radicals around the molecule. Since the damage range of single-linear oxygen radicals is extremely small, about 20 nm, it can achieve targeted destruction of target molecules. And then, porphyrins are selected as the molecules for the action of high-energy photons. This is because porphyrins possess life characteristics as key substances in plant photosynthesis and animal respiratory chains as well as many enzymes; and have a strong affinity for the lesion, aggregating at a concentration 10 times or even 20 times higher than that of the surrounding normal tissue. In addition, the differently bound porphyrins have specific targeting effects on specific sub-cells and even target molecules; they are very easy to activate and achieve energy conversion, forming single linear state oxygen radicals. Especially, the high energy targeted power therapy efficacy is not affected by oxygen, which makes Zeng Jun feel that the effect will be more obvious. “Because most tumors are hypoxic, and traditional radiation therapy and photodynamic therapy both require oxygen, lack of oxygen must have a negative impact on the therapeutic effect.” “With the guarantee of equipment and theoretical foundation, how to carry out high-energy targeted power therapy in clinical practice? Zeng Jun used the image of “mine warfare” to describe the whole process: firstly, the patient’s body is “mined with fuses”, that is, the above-mentioned porphyrins are used as a marker to track the tumor, called “fuses”. “Then, a special drug is used to localize the tumor cells by using the biological characteristics of the tumor and laying the “gunpowder”. After that, through high-energy photon and enzymatic binding reaction, the energy is transformed to “ignite” the fuse, and then the “gunpowder” is detonated, and the molecular target is applied to the starting point of tumor cell apoptosis and necrosis program, which rapidly leads to tumor cell death. In the whole process, will it cause damage to normal cells? For this concern of the reporter, Zeng Jun thinks it is not necessary. “Normal cells do not gather ‘fuses’ and ‘gunpowder’, and all the destructive effects are mainly aimed at tumor cells.” In fact, a large number of preclinical studies have also shown that high-energy photons and enzymatic binding reactions can activate photosensitizers that catalyze the production of singlet oxygen through physicochemical energy conversion. How the targeting effect is achieved depends on the porphyrin distribution, for example, porphyrin excitation in the mitochondria of tumor cells or other diseased cells promotes the production of singlet oxygen, leading to the opening of the inner mitochondrial membrane micropores and the overflow of cytochrome C and other key substances into the mitochondria, inducing apoptosis and necrosis of tumor cells. Meanwhile, the clinical treatment of small samples further confirmed the effectiveness of high-energy targeted kinetic therapy. In order to exclude differences between different tumors and different patients, the clinical study conducted by the team led by Zeng Jun adopted an own-control design. “That is, the same tumor patients who did not have remission after using chemotherapy, radiation therapy, or even surgery, were then treated with high-energy targeted power therapy, and then the before-and-after images were compared using PET/MR.” In the end, almost all of the patients achieved good treatment results. The reason for this is due to the fact that high-energy targeted power therapy concentrates the advantageous effects of chemotherapy and radiotherapy and uses oral amino acids as a means of synthesizing photosensitizers in vivo, enabling a strong affinity for diseased cells and thus very good targeting of the mutated cells, while itself having a non-toxic effect. “Only under high-energy photon excitation and biochemistry can the in vivo synthesized photosensitizer produce highly toxic singlet oxygen in the diseased cells. Thus, the therapy is capable of targeted destruction of diseased cells without the systemic toxic effects of chemotherapeutic drugs.” High-energy targeted kinetic therapy typically has a two-week duration, can be repeated and can be used in combination with conventional therapy, and is particularly effective for mid- to late-stage malignancies. “Because for tumors that have spread and metastasized, for tumors that are resistant or resistant to radiation, ‘fuzes’ and ‘gunpowder’ can instead gather better.” Radiodynamic therapy promises to be the most promising treatment for cancer, leukemia and vascular plaque, offering hope for saving 20 million patients each year. A new approach to the treatment of a major disease cannot be carried out without national support and global multicenter research. Zeng Jun hopes that the leaders of the Academy of Sciences and the Ministry of Health will organize relevant national units and experts to accelerate the development of radiodynamic therapy to benefit people’s livelihood.