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- Upper tract urothelial (transitional cell) carcinoma (UTUC) is a rare malignant disease occurring in roughly two people per 100 000 population. UTUCs comprise 5–10% of urothelial carcinomas. Given limited high-level evidence, Dr. Chang brings together two experts to discuss their approaches in various clinical scenarios. Sam Chang, MD hosts experts Eugene Pietzak, urologist, and Arjun Balar, medic...
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- In April 2020, the US Food and Drug Administration approved Jelmyto (mitomycin gel) as the first therapy for low-grade UTUC. One year later, Jelmyto has become a valuable treatment that urologists can incorporate into their clinical armamentarium. In this conversation with Sam Chang, Karim Chamie provides a state-of-the-art lecture on UTUC and treatment in 2021. Dr. Chamie summarizes risk stratifi...
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- Jonathan Coleman joins Sam Chang for a case-based clinical conversation on the management of upper tract urothelial carcinoma (UTUC). Dr. Coleman presents a case of a 71-year-old woman with microhematuria. Her CT scan identified a mass in the right renal pelvis and her cystoscopy was unremarkable. Dr. Coleman talks through the steps that were taken in the management of this case, which involved a...
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- Alicia Morgans and Petros Grivas discuss several ongoing or recently launched trials on urothelial carcinoma. Dr. Grivas provides an update on the ECOG-ACRIN 8192 trial for upper tract urothelial carcinoma, which follows the ECOG-ACRIN 8141 trial. The latter set a benchmark for expected pathological complete response rates with standard care chemotherapy for bladder cancer. The upcoming 8192 trial...
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- Urothelial carcinomas of the upper urinary tract (UTUCs) are rare, with poorer stage-for-stage prognosis than urothelial carcinomas of the urinary bladder. No international consensus exists on the benefit of adjuvant chemotherapy for patients with UTUCs after nephroureterectomy with curative intent. The POUT (Peri-Operative chemotherapy versus sUrveillance in upper Tract urothelial cancer) trial a...
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- Seth Lerner, MD, FACS, presents updated information on the United States Federal Drug Administration (FDA) approval of Jelmyto (UGN-101) for low-grade upper tract urothelial carcinoma (LG-UTUC), and the results of the OLYMPUS trial, Optimized DeLivery of Mitomycin for Primary UTUC Study (Olympus) . LG-UTUC is rare and previously there were few kidney-sparing options. UGN-101 is a mixture of a ther...
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- Seth Lerner and Sam Change discuss the recent phase 3 OLYMPUS study, published in The Lancet Oncology. Dr. Lerner was the principal investigator of the single-arm study which investigated the use of thermal-reversible gel mitomycin (Jelmyto) for low-grade upper tract urothelial cancer (UTUC). The study had a 59% complete response rate and thus identified and the FDA approved Jelmyto as a kidney-sp...
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- Zachary Klaassen, MD, MSc, and Christorpher Wallis, MD, Ph.D., discuss the OLYMPUS study of using UGN-101, a mitomycin-containing reverse thermal gel, for the treatment of Upper Tract Urothelial Carcinoma. The Food and Drug Administration approved mitomycin for adult patients with low-grade upper tract urothelial cancer (LG-UTUC). Efficacy determination was based on OLYMPUS, an ongoing, single-arm...
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- Alison Birtle and Surena Matin join Ashish Kamat for an educational session on the highly debated question of “should we use neoadjuvant or adjuvant therapy when it comes to upper tract urothelial carcinoma?” Dr. Birtle is the Chief Investigator of the POUT study and presents the side of adjuvant chemotherapy for the standard of care in patients with upper tract urothelial carcinoma. Dr. Matin pre...
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- Vitaly Margulis joins Ashish Kamat in a discussion on the top three developments in upper tract urothelial treatment starting with localized disease and moving onto the more advanced disease. With the difficulty in administering treatment in the upper tract, Dr. Margulis highlights intracavitary therapies, genetic changes that are prevalent in upper tract advanced disease, and the use of systemic...
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