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Diagnostics
GE Launches New Standard for Diagnosis of Urinary Bladder Cancer
1 in 5 patients with bladder tumors may receive more appropriate
treatment through the use of Hexvi fluorescence cystoscopy
GE Healthcare has recently announced the launch of a new standard for early
diagnosis of urinary bladder cancer through a new diagnostic agent called Hexvix
(hexaminolevulinate) at the 9th Asian Congress of Urology held in New Delhi.
Medical research has tried to address the difficulties in diagnosing bladder
cancer and this research eventually led to the development of Hexvix fluorescence
cystoscopy. "This technique involves instilling a photosensitising agent
— Hexvix into the bladder via a catheter leading to preferential intracellular
accumulation of photoactive (fluorescent) endogenous porphyrins in malignant
cells as opposed to non-malignant cells. Subsequently, illuminated with blue
light, the neoplastic lesions emit red fluorescence that stands out against
the normal mucosa," said Sarvadeep Sachdev, Director, Medical Diagnostics
Division, GE Healthcare South Asia.
"Smoking has been found to be a common etiological factor in 55 per cent
of the cases, out of which 45 per cent had smoked for more than 20 years, as
per our 1985 study. Apart from cigarette smoking, ‘beedi’ and ‘hukka’
smoking is more prevalent in India and in male population," says Prof.
Narmada Prasad Gupta, Chairman, Department of Urology at AIIMS, New Delhi.
Two multicentre phase III studies leading to the approval of Hexvix as a diagnostic
tool were conducted in Europe. The trials including 146 and 211 patients respectively
demonstrated the efficacy of the new technique. Both studies revealed that Hexvix
cystoscopy identified more patients with CIS bladder lesions than white light
cystoscopy, which is commonly used. In addition, Jocham et al indicated that
one in five patients may receive more appropriate treatment through the use
of Hexvix fluorescence cystoscopy.
A recent Phase III study, involving 789-patients, compared Hexvix with standard
white-light cystoscopy, and found that Hexvix was significantly better at detecting
non-invasive bladder cancer. Recurrence of bladder cancer nine months after
the initial procedure was also significantly reduced in the Hexvix group, informed
Sachdev.
"Hexvix fluorescence cystoscopy is a new diagnostic tool with high sensitivity
for detecting bladder tumors, in particular CIS tumors," explained Prof
Karl-Dietrich Sievert, MD, PhD, Professor of Urology, Vice Chair Department
of Urology, University of Tübingen, Germany.
"A statistically significant superiority of fluorescence cystoscopy over
standard cystoscopy in the detection of CIS has been established in all published
studies to date. Its high sensitivity and negative predictive value improves
the diagnosis of malignancies and of CIS tumors. The cases missed by white-light
inspection were typically CIS lesions, confirming the superiority of Hexvix
fluorescence cystoscopy in these cases,” said Sachdev.
Since 2006, more than 500 institutions have adopted this technique throughout
Europe, where Hexvix is already available, because better margin detection and
more lesions being detected result in overall better transurethral resections
of the bladder, added Sachdev.
EH News Bureau
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