Journal article
Efficacy and safety of mitomycin gel (UGN-101) as an adjuvant therapy after complete endoscopic management of Upper Tract Urothelial Carcinoma
The Journal of urology, Vol.209(5), pp.872-881
05/2023
DOI: 10.1097/JU.0000000000003185
PMID: 36657029
Abstract
To describe a novel application of the reverse thermal polymer gel of mitomycin C (UGN-101) as adjuvant therapy after complete endoscopic ablation of upper tract urothelial carcinoma (UTUC).
We retrospectively reviewed patients treated with UGN-101 from 15 high-volume centers. Adjuvant therapy was defined as treatment administered following visually complete endoscopic ablation. Response at primary endoscopic evaluation was defined as no visual tumor or negative biopsy. Ipsilateral disease free and progression free survival were estimated by the Kaplan Meier method. Ureteral stenosis and other adverse events were abstracted from the medical records. Ureteral stenosis was defined as a condition requiring ureteral stent or nephrostomy or would typically warrant stent or nephrostomy.
Adjuvant use of UGN-101 after complete endoscopic ablation was used in 52 of 115 (45%) renal units in the oncologic analysis. At first endoscopic evaluation, 36/52 (69%) were without visible disease. At 6.8 months median follow up, the ipsilateral disease-free rate was 63%. Recurrence after adjuvant UGN101 therapy was more likely in multifocal tumors compared to unifocal (HR 3.3 95%CI 1.07-9.91). Compared with UGN-101 treatment for chemoablation of measurable disease, there were significantly fewer disease detections with adjuvant therapy (p<.001). Ureteral stenosis after UGN 101 was diagnosed in 10 patients (19%) undergoing adjuvant therapy compared to 17 (29%) undergoing chemoablative therapy (p=0.28).
In patients being considered for UGN-101, maximal endoscopic ablation prior to UGN-101 treatment may result in fewer patients with disease at first endoscopy and possibly fewer adverse events than primary chemoablative therapy. Longer follow up is needed to determine if UGN-101 after complete endoscopic ablation will lead to durable disease-free interval.
Details
- Title: Subtitle
- Efficacy and safety of mitomycin gel (UGN-101) as an adjuvant therapy after complete endoscopic management of Upper Tract Urothelial Carcinoma
- Creators
- Craig Labbate - The University of Texas MD Anderson Cancer CenterSolomon Woldu - The University of Texas Southwestern Medical CenterKatie Murray - University of MissouriKyle Rose - Moffitt Cancer CenterWade Sexton - Moffitt Cancer CenterIsamu Tachibana - Indiana UniversityHristov Kaimakliotis - Indiana UniversityJoseph Jacob - SUNY Upstate Medical UniversityRian Dickstein - University of Maryland Medical CenterJennifer LinehanAlan Nieder - Mount Sinai Medical CenterMarc Bjurlin - University of North Carolina Medical Center, Chapel Hill, NCMitchell Humphreys - Mayo Clinic Cancer Center, Phoenix, AZSaum Ghodoussipor - Rutgers Cancer Institute of New Jersey, New Brunswick, NJMarcus Quek - Loyola University Medical CenterMichael O'Donnell - University of IowaBrian Eisner - Massachusetts General HospitalAdam Feldman - Massachusetts General HospitalYair Lotan - The University of Texas Southwestern Medical CenterSurena F Matin - The University of Texas MD Anderson Cancer Center
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.209(5), pp.872-881
- DOI
- 10.1097/JU.0000000000003185
- PMID
- 36657029
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Electronic publication date
- 01/19/2023
- Date published
- 05/2023
- Academic Unit
- Urology
- Record Identifier
- 9984361749102771
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