The following is a summary of “Early experience with UGN-101 for the treatment of upper tract urothelial cancer – A multicenter evaluation of practice patterns and outcomes,” published in the March 2023 issue of Urologic Oncology by Woldu et al.

The UGN-101 is an innovative method of administering therapeutic agents for treating upper tract urothelial cancer (UTUC) through intracavitary means. Based on a pivotal trial, UGN-101 has been approved for treating small-volume residual low-grade UTUC. The objective was to present researchers’ observations regarding using UGN-101 in a diverse and practical clinical environment. A retrospective analysis was conducted on all cases involving UGN-101 across 15 institutions, emphasizing examining practice patterns, efficacy, and adverse effects. The utilization of UGN-101 is incorporated in both the chemoablative and adjuvant settings. 

A sum of 136 renal units was subjected to treatment in 132 patients. Most instances were confirmed by biopsy to be low-grade UTUC. The observed practice patterns exhibited significant variability. The predominant method of administration involved antegrade instillation through a percutaneous nephrostomy. In the adjuvant setting, a significant proportion of patients (69%) achieved disease-free status during their initial endoscopic evaluation. However, in the chemoablative setting, only 37% of patients were endoscopically clear during their first evaluation, which was statistically significant (P<0.001). 

Patients with smaller tumor sizes before UGN-101 induction exhibited a higher complete response. Low-volume residual disease, specifically those less than 1 cm, was associated with a 70% complete response rate. This rate is comparable to the disease-free rate observed during the initial endoscopic evaluation when UGN-101 was administered in the adjuvant setting. In 27% of cases, the administration of UGN-101 maintenance doses was documented. The incidence rate of new-onset, clinically significant ureteral stenosis was 23%. This study constitutes the most extensive analysis of individuals who underwent treatment with UGN-101 and may provide a foundation for continuing conjectures concerning the use of UGN-101 for UTUC therapy.

Source: sciencedirect.com/science/article/abs/pii/S107814392200429X