Generally speaking, photodynamic therapy (PDT) for cancer has been viewed primarily as a therapeutic approach. In recent years, the integration of photodynamic therapy with secondary treatments has led to a deeper understanding of the sub-therapeutic photodynamic priming effects of PDT. In this work we show that stromal modulation by photodynamic priming of orthotopic head and neck tumors improved the tumor delivery and diagnostic accuracy of the clinical fluorescence image-guided surgery (IGS) probe Cetuximab-IRDye800CW (Cet-IRDye800) by 264.2%. We also explore the role of photodynamic priming in alleviating desmoplasia by reducing the density (>90%) and alignment (>10^3-fold) of collagen fibrillar networks in pancreatic tumors. In doing so, photodynamic priming using EGRF targeted multi-inhibitor liposomes containing irinotecan induced 90% tumor growth inhibition at only 8.1% of the patient equivalent dose of irinotecan, and double overall survival.
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