Early experience with UGN-101 for the treatment of upper tract urothelial cancer - A multicenter evaluation of practice patterns and outcomes. Journal Article

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Authors: Woldu, SL; Labbate, C; Murray, KS; Rose, K; Sexton, W; Tachibana, I; Kaimakliotis, H; Jacob, J; Dickstein, R; Linehan, J; Nieder, A; Bjurlin, MA; Humphreys, M; Ghodoussipor, S; Quek, ML; O'Donnell, M; Eisner, BH; Feldman, AS; Matin, SF; Lotan, Y
Article Title: Early experience with UGN-101 for the treatment of upper tract urothelial cancer - A multicenter evaluation of practice patterns and outcomes.
Abstract: BACKGROUND: UGN-101 is a novel delivery system for intracavitary treatment of upper tract urothelial cancer (UTUC). UGN-101 was approved based on a pivotal trial for small volume residual low-grade UTUC. Our aim was to report our experience with UGN-101 in a more heterogenous and real-world setting. METHODS: We performed a retrospective review of all UGN-101 cases from 15 institutions with a focus on practice patterns, efficacy, and adverse effects. We include UGN-101 utilization in both the chemoablative and adjuvant setting. RESULTS: There were a total 136 renal units treated from 132 patients. The majority of cases were biopsy proven low-grade UTUC. Practice patterns varied considerably - the most common administration technique was antegrade instillation via a percutaneous nephrostomy. When utilized in the adjuvant setting, 69% of patients were disease free at the time of their first endoscopic evaluation, while in the chemoablative setting, 37% were endoscopically clear on the first evaluation (P 0.001). Complete response was higher in patients with smaller tumor size prior to UGN-101 induction; low volume (1 cm) residual disease was associated with a 70% complete response, similar to disease free rate at first endoscopic evaluation when UGN-101 was used in the adjuvant setting. The use of maintenance doses of UGN-101 was reported in 27% of cases. The overall incidence of new onset, clinically significant ureteral stenosis was 23%. CONCLUSIONS: This study represents the largest review of patients treated with UGN-101 and can serve as a basis of ongoing hypotheses regarding treatment with UGN-101 for UTUC.
Journal Title: Urologic oncology
ISSN: 1873-2496; 1078-1439
Publisher: Elsevier Inc  
Date Published: 2022