March 3, 2011
5-ALA clinical trial opens for patients with brain tumors called gliomas
University of Washington Medical Center is the first center in a five-state region to be approved by the United States Food and Drug Administration (FDA) to use an experimental drug called 5-aminolevunilic acid (5-ALA) to help locate brain tumors by using a fluorescent light during surgery.
Although this drug has been used to destroy cancer cells with photodynamic therapy for the past 30 years, UW Medical Center is one of only a few American hospitals that are currently exploring the safety and efficacy of this drug to improve surgery for malignant gliomas. It is the only center conducting this clinical trial in the Washington, Wyoming, Alaska, Montana and Idaho region.
Following large, randomized, prospective studies in Europe, several European countries have already approved, and are now using, 5-ALA for improved glioma surgery. The compound is taken by mouth.
Gliomas originate in the glial cells, which surround and support nerve cells. The most common location for gliomas is the brain. Glioma incidence is rising in the United States. An estimated 12,000 people die each year from this tumor. These high-grade gliomas are often fast-growing, so improved treatment options are critical.
Because gliomas lack easily identifiable margins, 5-ALA provides the neurosurgeon with an important option that potentially enables better identification of invasive tumor.
Unlike normal body tissues, high-grade gliomas break down 5-ALA into a fluorescent compound called a “photoporphyrin,” a structure similar to that of chlorophyll found in plants.
Tumors that absorb this compound fluoresce with UV light exposure. A specially modified surgical microscope that contains a UV light bulb enables the neurosurgeon to see the glowing tumor tissue and helps guide removal of the tumor.
Dr. Daniel Silbergeld, UW professor of neurological surgery and Chief of Neurological Surgery at UW Medical Center, is spearheading this effort.
The UW Medicine Neurosciences Institute offers patients coordination of care within the UW Medicine Health System that includes Harborview, UW Medical Center, Northwest Hospital, UW Neighborhood Clinics, UW School of Medicine, UW Physicians and Airlift Northwest. The multidisciplinary team of UW Medicine experts performs over 600 brain tumor surgeries each year. The team includes neurosurgeons, neurologists, rehabilitation specialists, psychiatrists, neuro-radiologists, neuro-oncologists, and neuro-ophthalmologists working together to provide patients with the best possible health outcomes.