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Photo-dynamic versus white light-guided treatment of non-muscle invasive bladder cancer: randomised phase III trial of clinical and cost-effectiveness


Disease site: Bladder cancer

Treatment modality: Surgery

Status: Closed


Trial details

PHOTO is a pragmatic, multicentre, randomised controlled phase III trial, investigating the efficacy of using photo-dynamic diagnosis (PDD) under blue light – instead of white light – for transurethral resection of bladder tumour (TURBT) in intermediate and high risk non-muscle invasive bladder cancer.


533 patients will be recruited from UK sites. Half of the participants will undergo surgery using PDD under blue light. The other participants will undergo surgery using standard white light. All participants will be followed up regularly during the three year trial period.

The PHOTO trial is managed by ICR and CHaRT.



View and download a lay summary of the PHOTO results.


Further information

Chief Investigator: Professor Rakesh Heer, The Newcastle upon Tyne Hospitals NHS Foundation Trust

ICR-CTSU Scientific Lead: Professor Emma Hall

Trial management contacts: [email protected] and [email protected]


Sponsor: The Newcastle upon Tyne Hospitals NHS Foundation Trust

Funding: National Institute for Health Research


View PHOTO on the National Institute for Health Research website: NIHR - Be Part Of Research

Read a plain English summary of PHOTO from Cancer Research UK.


Publications and presentations

Rakesh Heer, Rebecca Lewis, Anne Duncan, Steven Penegar, Thenmalar Vadiveloo, Emma Clark, Ge Yu, Paramananthan Mariappan, Joanne Cresswell, John McGrath, James N’Dow, Ghulam Nabi, Hugh Mostafid, John Kelly, Craig Ramsay, Henry Lazarowicz, Angela Allan, Matthew Breckons, Karen Campbell, Louise Campbell, Andy Feber, Alison McDonald, John Norrie, Giovany Orozco-Leal, Stephen Rice, Zafer Tandogdu, Ernest Taylor, Laura Wilson, Luke Vale, Graeme MacLennan & Emma Hall. - Photodynamic versus white-light-guided resection of first-diagnosis non-muscle-invasive bladder cancer: PHOTO RCT


Rakesh Heer, F.R.C.S.(Urol), Rebecca Lewis, B.Sc., Thenmalar Vadiveloo, Ph.D., Ge Yu, Ph.D., Paramananthan Mariappan, F.R.C.S.(Urol), Joanne Cresswell, F.R.C.S.(Urol), John McGrath, F.R.C.S.(Urol), Ghulam Nabi, F.R.C.S.(Urol), Hugh Mostafid, F.R.C.S.(Urol), Henry Lazarowicz, F.R.C.S.(Urol), John Kelly, F.R.C.S.(Urol), Anne Duncan, B.Sc., Steven Penegar, B.Sc., Matt Breckons, Ph.D., Laura Wilson, B.Sc., Emma Clark, Ph.D., Andy Feber, Ph.D., Giovany Orozco-Leal, M.Sc., Zafer Tandogdu, Ph.D., Ernest Taylor, James N’Dow, F.R.C.S.(Urol), John Norrie, M.Sc., Craig Ramsay, Ph.D., Stephen Rice, Ph.D., Luke Vale, Ph.D., Graeme MacLennan, M.Sc., and Emma Hall, Ph.D. - A Randomized Trial of PHOTOdynamic Surgery in Non–Muscle-Invasive Bladder Cancer NEJM Evidence


Zafer Tandogdu, Rebecca Lewis, Anne Duncan, Steven Penegar, Alison McDonald, Luke Vale, Jing Shen, John D Kelly, Robert Pickard, James N Dow, Craig Ramsay, Hugh Mostafid, Paramananthan Mariappan, Ghulam Nabi, Joanne Creswell, Henry Lazarowicz, John McGrath, Ernest Taylor, Emma Clark, Graeme Maclennan, John Norrie, Emma Hall, Rakesh Heer. - Photodynamic versus white light-guided treatment of non-muscle invasive bladder cancer: a study protocol for a randomised trial of clinical and cost-effectiveness. BMJ Open 2019;9:e022268. doi: 10.1136/bmjopen-2018-022268

Clinical trials

Division of Clinical Studies

The division carries out or coordinates high-quality trials and translational research at both an early phase – typically to test new targeted drugs – and a later stage.