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- Eugene Pietzak details the molecular landscape of upper tract urothelial carcinoma and highlights practical clinical implications of recent findings of the molecular biology of upper tract urothelial cancer, with a particular focus on what is relevant to the urologist in this conversation with Sam Chang. Upper tract urothelial cancer comprises a very small proportion of all urothelial cancer. it h...
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- In this patient case evaluation discussion, Surena Matin joins Sam Change presenting a patient case of low grade, upper tract, urothelial cancer. This was a 71-year-old patient who presented with microhematuria and he was found to have a 7 mm lesion in the distal, right ureter. Drs. Matin and Chang discuss diagnosing and staging the patient, and Dr. Matin talks through his approach to treatment. G...
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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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- In a comprehensive discussion hosted by Ashish Kamat, Bishoy Faltas delves into the genomics of upper tract urothelial carcinoma (UTUC). Dr. Faltas emphasizes the distinct biological differences between UTUC and bladder urothelial carcinoma (BUC), notably in genomic and transcriptomic features. He discusses the advanced stage at which UTUC often presents and the role of environmental exposures. Ke...
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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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- 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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- 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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