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A drink taken before brain surgery that makes high-grade glioma glow under blue light, letting surgeons remove more tumour safely.
Oral 5-aminolevulinic acid is taken up by glioma cells and converted to protoporphyrin IX, which fluoresces pink-red under blue light at 400 to 410 nm through the surgical microscope, so the surgeon can distinguish tumour from brain and resect more of it while sparing normal tissue. Stummer's randomised trial (Lancet Oncology 2006) showed complete resection in 65% versus 36% of patients and better six-month progression-free survival. The EMA approved it in 2007 for WHO grade III and IV glioma surgery and the FDA in 2017, the first optical imaging agent for brain surgery. The trial was not powered for overall survival. Related aminolevulinate compounds are used topically for actinic keratosis photodynamic therapy (Levulan, Ameluz) and in the bladder (hexaminolevulinate). It is a drink that makes brain tumours glow.
Oral 5-ALA is taken up by glioma cells and converted to protoporphyrin IX, which fluoresces pink-red under blue light (400-410 nm) through the surgical microscope.
1.5-Aminolevulinic acid (oral, for glioma surgery) slips into a pocket on its target.
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance: how tumours escape each drug class · Lines of therapy.
Oral solution given two to four hours before glioma surgery in the hospital, so it is a surgical supply bundled into the Part A inpatient stay rather than a pharmacy benefit.
Bundled into the craniotomy claim; no separate authorisation is typical.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B) · Medicare.gov: Inpatient hospital care (Part A). Not medical or financial advice; verify with your plan.
Sources: NICE search: 5-aminolevulinic acid (Gliolan). Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Compare all products across the US, EU, UK, Japan, China and Australia →
| Region | Year | Indication |
|---|---|---|
| EU | 2007 | Visualisation of malignant tissue during surgery for WHO grade III-IV glioma |
| US | 2017 | Imaging agent for visualisation of malignant tissue during glioma surgery (suspected high-grade) |
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Query for this drug: (TITLE:"5-Aminolevulinic acid" OR ABSTRACT:"5-Aminolevulinic acid" OR TITLE:"oral, for glioma surgery" OR ABSTRACT:"oral, for glioma surgery" OR TITLE:"Gleolan" OR ABSTRACT:"Gleolan" OR TITLE:"Gliolan" OR ABSTRACT:"Gliolan") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about 5-Aminolevulinic acid (oral, for glioma surgery), not a curated reading list.
Shares Optical & fluorescence imaging, Fluorescence-guided surgery, Multiple myeloma and the tag diagnostic.
Shares Optical & fluorescence imaging, Fluorescence-guided surgery and the tag diagnostic.
Shares Glioma & glioblastoma, Multiple myeloma and the tag diagnostic.
Shares Optical & fluorescence imaging, Fluorescence-guided surgery.
Shares Optical & fluorescence imaging, Fluorescence-guided surgery.
Shares Optical & fluorescence imaging, Fluorescence-guided surgery.