5-ALA Clinical Trial Open to Help Patients With Gliomas

Principal Investigator: Daniel Silbergeld, MD

The University of Washington Medical Center is the first center in the WWAMI states 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 intra-operatively using fluorescent light.

Although this drug has been used to destroy cancer cells with photodynamic therapy for the last 30 years, the UW Medical Center is one of only a few hospitals in the United States that are currently exploring the safety and efficacy of this oral compound to improve surgery for malignant gliomas. Following large, randomized, prospective studies in Europe, several European countries have already approved, and are currently using, 5-ALA for improved glioma surgery.

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. Compared to normal tissue, 5-ALA is metabolized by high-grade gliomas to 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, using a specially modified surgical microscope that contains a UV light bulb enabling the neurosurgeon to see the glowing tumor tissue and help guide excision of the tumor.

UW Medical Center is now using 5-ALA in surgery. For more information about this trial, contact Dr. Daniel Silbergeld, Professor of Neurological Surgery, by calling Laurie Lee, ARNP at 206-543-3418.