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Kidney-Sparing Alternative Treatment of Low-Grade Upper Tract Urothelial Carcinoma

By: Julia Fiederlein
Posted: Wednesday, January 20, 2021

Nonsurgical chemoablative treatment of low-grade upper tract urothelial carcinoma with UGN-101 seemed to produce durable responses for up to 12 months, according to Surena F. Matin, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues. The final results of the multicenter phase III OLYMPUS trial were featured in the Best of Bladder Cancer session during the virtual edition of the 2020 Society of Urologic Oncology (SUO) Annual Meeting.

“UGN-101 is a reverse thermal gel-containing mitomycin that is instilled into the renal pelvis as a viscous liquid and converts to gel at body temperature, thereby optimizing drug exposure at the target area for 4 to 6 hours,” the investigators explained. “UGN-101 offers a kidney-sparing alternative for the treatment of low-grade upper tract urothelial carcinoma that reduces disease recurrence and avoids the morbidity associated with radical nephroureterectomy.”

A total of 71 patients with biopsy-proven disease were administered UGN-101 via a retrograde catheter to the renal pelvis and calyces. More than half of patients (58%) achieved a complete response at the primary disease evaluation. The majority of patients (71%) received at least one dose of a maintenance regimen. At 12 months, complete responses were maintained in 74.2% of the evaluable patients. In 56.0% of those who achieved a complete response at the primary disease evaluation, the probability a patient would remain disease-free was estimated at 81.8%. The median time to disease recurrence was not reached. Maintenance treatment did not seem to impact the durability of response.

No treatment-related deaths were reported. Ureteric stenosis, urinary tract infection, hematuria, flank pain, nausea, dysuria, renal dysfunction, abdominal pain, and vomiting were among the most frequently reported adverse events. Compared with the overall population, patients who received induction treatment seemed to experience ureteric stenosis at a lower rate (44% vs. 29%, respectively).

Disclosure: No information regarding conflicts of interest was provided.



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