Optimal use of bladder Ca detection agent outlined

Blue light cystoscopy with hexaminolevulinate HCl (HAL-BLC) should be considered for initial diagnosis of nonmuscle-invasive bladder cancer, an expert panel of urologists recently concluded.

That recommendation and others concerning the optimal use of HAL-BLC (Cysview, Oslo, Norway) were published by a panel of 16 American urologists and one European urologist form of an expert consensus statement online in Nature Reviews Urology (Sept. 23, 2014).

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Hexaminolevulinate is a tumor photosensitizer that is used in combination with blue-light cystoscopy (BLC) as an adjunct to white-light cystoscopy (WLC) in the diagnosis and management of nonmuscle-invasive bladder cancer (NMIBC).

For the statement, the panel reviewed existing published clinical evidence supporting the use of HAL-BLC for patients with NMIBC, including European recommendations for its use, and provided their own expert opinion on which patients should receive HAL-BLC.

“The consensus panel recommendation outlines how urologists should incorporate HAL-BLC into their clinical practice for the management of bladder cancer and the appropriate patient types that would benefit from the technology. HAL-BLC results in a more complete transurethral resection of bladder tumors and more accurate staging, resulting in more appropriate management decisions. The evidence shows not only reduced risk of recurrence but also prolonged time to recurrence,” lead author Sia Daneshmand, MD, of the Institute of Urology, Norris Comprehensive Cancer Center at the University of Southern California, Los Angeles, said in a press release from manufacturer Photocure ASA.

The panel recommended that HAL-BLC should be considered:

• for initial diagnosis of NMIBC

• for detection of recurrent tumors

• in patients with positive urine cytology but negative WLC findings

• for optimal tumor staging.

The panel concluded that extensive evidence and clinical experience show that HAL-BLC can improve the detection of NMIBC beyond that achieved with WLC, the current standard of care, Photocure said.

Several of Dr. Daneshmand’s co-authors have served as consultants, advisers, or on membership, advisory committee, or review panels for Photocure.

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