Hexaminolevulinate: a profile of its use with blue-light cystoscopy in the diagnosis of bladder cancer

Abstract

Hexaminolevulinate [Cysview® (USA); Hexvix® (EU)], an ester derivative of 5-aminolevulinate, is a valuable option for the diagnosis of bladder cancer when used in conjunction with blue-light (BL) cystoscopy. In clinical trials, the addition of hexaminolevulinate-guided BL cystoscopy to white-light (WL) cystoscopy was generally better at detecting non-muscle-invasive bladder cancer lesions than WL cystoscopy alone, as assessed by a number of endpoints (e.g. increased number and rate of lesion detection), leading to increased rates of complete treatment decisions. Add-on hexaminolevulinate-guided BL cystoscopy reduced tumour recurrence rates relative to WL cystoscopy alone in follow-up studies and, although further studies are needed, may potentially improve survival-related outcomes. Hexaminolevulinate is generally very well tolerated when used to guide BL cystoscopy, with the most common adverse events (i.e. haematuria, dysuria, pain and bladder spasm) being expected as a consequence of the resection procedure.