The following is a summary of “Sequential endoluminal gemcitabine and docetaxel for the treatment of clinically non-invasive high-grade upper tract urothelial carcinoma,” published in the January 2024 issue of Urology by McElree, et al.
There is a need for successful treatments for upper tract urothelial cancer (UTUC) that do not harm the kidneys. Gemcitabine/Docetaxel (Gem/Doce) is effective in treating bladder cancer that hasn’t spread to muscles.
For a study, researchers sought to discuss the outcomes of endoluminal Gem/Doce therapy in patients with noninvasive high-grade UTUC.
It was decided to look back at all the patients who had Gem/Doce treatment for high-grade UTUC that was clinically benign and had no obvious disease on x-rays or endoscopies, either at the time of diagnosis or after ablation. A nephrostomy or a backward ureteral tube was used to give the treatment. Induction instillations were done once a week for six weeks and then every six months if the animals were healthy. A recurrence was described as cancer that was proven by a tissue or high-grade (HG) cytology. The cancer spreads to muscles, tumors show up, or the person dies from cancer. Kaplan-Meier was used to figure out how long people would live.
The last group had 31 patients with 41 upper tract units. Of these, 51% would have needed dialysis after nephroterectomy. Most people were 74 years old (IQR: 68–81). It took 29 months on average (IQR 20–58) to follow up. Before treatment, 37 (90%) units had a localizing HG cytology( (presumed occult CIS), and 4 (9.8%) had HG biopsy-proven disease. Fifteen patients (52%) said they had any side effects, five of which were Grade 3 and one Grade 5. Seventy-six percent of people who didn’t have a recurrence lived for one, two, or three years. Urothelial cancer killed five people. Overall survival at 3 years was 75%, and progression-free survival was 75%. Gem/Doce shows favorable safety and efficacy as a renal-preserving therapy for appropriately chosen patients with high-grade UTUC.
Source: sciencedirect.com/science/article/abs/pii/S1078143923002892