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.
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.
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%.
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.
Urologic oncology. 2022 Nov 21 [Epub ahead of print]
Solomon L Woldu, Craig Labbate, Katie S Murray, Kyle Rose, Wade Sexton, Isamu Tachibana, Hristos Kaimakliotis, Joseph Jacob, Rian Dickstein, Jennifer Linehan, Alan Nieder, Marc A Bjurlin, Mitchell Humphreys, Saum Ghodoussipor, Marcus L Quek, Michael O'Donnell, Brian H Eisner, Adam S Feldman, Surena F Matin, Yair Lotan
University of Texas Southwestern Medical Center, Dallas, TX., University of Texas MD Anderson Cancer Center, Houston, TX., University of Missouri, Columbia, MO., Moffitt Cancer Center, Tampa, FL., Indiana University Medical Center, Indianapolis, IN., State University of New York Upstate Medical Center, Syracuse, NY., University of Maryland Medical Center, Baltimore, MD; Chesapeake Urology, Baltimore, MD., Providence Specialty Medical Group, Santa Monica, CA., Mount Sinai Medical Center, Miami Beach, FL., Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC., Mayo Clinic Cancer Center, Phoenix, AZ., Rutgers Cancer Institute of New Jersey, New Brunswick, NJ., Loyola University Medical Center, Maywood, IL., University of Iowa Health Care, Iowa City, IA., Massachusetts General Hospital, Boston, MA., University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: .