A study of 5-ALA in bowel cancer surgery (GLiSten)

Cancer type:

Bowel (colorectal) cancer

Colon cancer

Status:

Results

Phase:

Other

This study was done to see if a substance called 5-ALA and a special light could help surgeons see lymph nodes that contain bowel cancer cells.

More about this trial

The most common place for bowel cancer to spread is the lymph nodes. When people have surgery to remove bowel cancer, the surgeon also removes some of the lymph nodes to check whether they contain cancer cells or not. It is important to know, as it can affect the treatment a person needs.

In this study, researchers used a substance called 5-ALA which can make cancer cells glow under a blue light.

When this study was done, surgeons had used 5-ALA to help diagnose other cancers. But they hadn’t used it for bowel cancer before.

The people taking part in this study had a drink containing 5-ALA a few hours before their operation. They then had keyhole surgery to remove their bowel cancer.

The surgeons looked at the lymph nodes under a special light to see if they glowed. They then removed the lymph nodes as usual, which were analysed in the laboratory to see if they contained cancer cells.

The aim of the study was to find the best dose of 5-ALA that will make bowel cancer cells glow under the blue light during surgery.

Summary of results

The study team found that 5-ALA did not make it easier to identify lymph nodes that contained bowel cancer cells.

This trial was open for people to join between 2013 and 2015, and the study team published the results in 2016.

About this study

There were 2 groups in this study. One had a lower dose of 5-ALA, and the other had a higher dose. Everyone taking part had bowel cancer and was due to have surgery.

40 people took part is this study:

17 had the lower dose of 5-ALA
23 had the higher dose of 5-ALA

Results for people who had the lower dose

Of the 17 people who had the lower dose, 3 people had lymph nodes which glowed under the special light during surgery. But laboratory analysis showed that only 1 of these contained cancer cells. The other 2 didn’t contain cancer cells.

The research team analysed all the lymph nodes in the lab. The results showed that 9 people had cancer cells in their lymph nodes. But only 1 of these had glowed under the light during surgery. The other 8 looked like normal lymph nodes under the special light.

Results for people who had the higher dose

Of the 23 people who had the higher dose, 4 people had lymph nodes which glowed under the special light during surgery. But laboratory analysis showed that none of these contained cancer cells.

The research team analysed all the lymph nodes in the lab. The results showed that 7 people had cancer cells in their lymph nodes. But none of these had glowed under the light during surgery. All 7 looked like normal lymph nodes under the special light.

Side effects

5-ALA caused very few side effects:

2 people were slightly more sensitive to light than usual for a few days
4 people had a short term rise in a one of the enzymes found in the liver

Conclusion

The research team concluded that 5-ALA was not useful for identifying lymph nodes that contained bowel cancer cells. They cannot recommend that 5-ALA is used as part of assessment and diagnosis for people with bowel cancer.

Sometimes studies show that something doesn’t work as well as we’d hoped. But all results are useful. They add to our knowledge and understanding of cancer and how to treat it.

Where this information comes from

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item

) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.