Antegrade Instillation of UGN-101 (Mitomycin for Pyelocalyceal Solution) for Low-Grade Upper Tract Urothelial Carcinoma: Initial Clinical Experience

Rosen, Geoffrey; Nallani, Ankita; Muzzey, Catherine; Murray, Katie S.

doi:10.1097/ju.0000000000002454

Cited by 15 publications

(11 citation statements)

References 20 publications

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“…27 UGN-101 is administered into the upper tract either retrograde under fluoroscopic guidance or antegrade via a nephrostomy tube. 28,29 UGN-102 is a similar reverse thermal gel containing mitomycin at a lower concentration (1.33 mg/mL). Its administration is simpler than UGN-101 since it can be delivered via urethral catheter in an ambulatory setting.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Low-grade Intermediate-risk Nonmuscle-invasive Bladder Cancer With UGN-102 ± Transurethral Resection of Bladder Tumor Compared to Transurethral Resection of Bladder Tumor Monotherapy: A Randomized, Controlled, Phase 3 Trial (ATLAS)

Prasad,

Huang,

Shore

et al. 2023

Journal of Urology

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Section: Discussionmentioning

confidence: 99%

“…27 UGN-101 is administered into the upper tract either retrograde under fluoroscopic guidance or antegrade via a nephrostomy tube. 28,29…”

Section: Discussionmentioning

confidence: 99%

Treatment of Low-grade Intermediate-risk Nonmuscle-invasive Bladder Cancer With UGN-102 ± Transurethral Resection of Bladder Tumor Compared to Transurethral Resection of Bladder Tumor Monotherapy: A Randomized, Controlled, Phase 3 Trial (ATLAS)

Prasad,

Huang,

Shore

et al. 2023

Journal of Urology

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“…Four (50%) of them showed complete response at first follow-up ureteroscopy. Five adverse events were observed in three patients: three grade 1, one grade 2, and one grade 3 (mid ureteral stricture) [29 ▪▪ ]. A multiinstitutional retrospective series including 32 patients treated with antegrade instillations of UGN-101 was then published.…”

Section: Technologies To Improve the Efficacy Of Endoscopic Treatment...mentioning

confidence: 99%

New technologies for nephron-sparing surgery in upper urinary tract cancers

Gallioli,

Basile,

Territo

et al. 2023

Current Opinion in Urology

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Purpose of review Nephron-sparing surgery (NSS) is the preferred treatment in patients with low-risk upper tract urothelial carcinoma (UTUC). Improving both instruments and topical chemotherapy regimens efficacy is crucial to achieve better outcomes. The purpose of this review is to summarize the most recent evidence on technological advances for the conservative management of UTUC with implications on diagnosis and treatment. Recent findings Novel diagnostic tools, lasers, and topical chemotherapy systems delivery have been implemented to optimize NSS outcomes for UTUC. Summary Photodynamic ureteroscopy has been reported to improve cancer detection rate as compared with conventional imaging or ureteroscopy, especially in case of carcinoma in situ. However, refinements in photosensitizer administration and dedicated instruments are needed. The armamentarium of lasers for UTUC ablation is composed of several devices with peculiar characteristics. Together with Ho:YAG and Tm:YAG lasers, the Thulium Fiber Laser (TFL) is gaining momentum in UTUC ablation. Strengths and weaknesses of each laser must be considered to maximize oncological and safety outcomes. Several novel endocavitary chemotherapy delivery systems have been tested to reduce tumor recurrence and progression after NSS. Administration of gel-based chemotherapeutic agents has been proven to be effective in humans; conversely, drug-eluting ureteral stent systems are still conceptual.

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“…Percutaneous nephrostomy tubes were inserted by interventional radiology under image guidance. An antegrade nephrostogram was performed to confirm correct PCNT positioning within the renal collecting system, and no collecting system injury [15]. Renal pelvis volume measurement was performed either at the time of index ureteroscopy via retrograde catheterization similar to the OLYMPUS trial, or at the time of nephrostomy insertion.…”

Section: Administrationmentioning

confidence: 99%

“…Adverse events included fatigue (27%), flank pain (19%), UTI (12%), sepsis (8%) and haematuria (8%). Ureteric stenosis occurred in three patients (9%) at a median (IQR) 17 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) weeks after the last dose of therapy. None of these patients had a history of UTUC or prior ureteroscopies before the index diagnostic endoscopy.…”

Section: Safety Analysismentioning

confidence: 99%

Antegrade administration of mitomycin gel for upper tract urothelial carcinoma via percutaneous nephrostomy tube: a multi‐institutional retrospective cohort study

et al. 2022

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To assess the safety profile of antegrade mitomycin gel instillation through a percutaneous nephrostomy tube (PCNT) for upper tract urothelial carcinoma (UTUC) with the aim of decreasing morbidity associated with therapy. Patients and MethodsPatients undergoing antegrade administration of mitomycin gel via PCNT were retrospectively included for analysis from four tertiary referral centres between 2020 and 2022. The primary outcome was safety profile, as graded by Common Terminology Criteria for Adverse Events (v5.0). Post-therapy disease burden was assessed by primary disease evaluation (PDE) via ureteroscopy. ResultsThirty-two patients received at least one dose of mitomycin gel via PCNT for UTUC, 29 of whom completed induction and underwent PDE. Thirteen patients (41%) had residual tumour present prior to induction therapy. At a median of 15.0 months following first dose of induction therapy, ureteric stenosis occurred in three patients (9%), all of whom were treated without later recurrence or chronic stenosis. Other adverse events included fatigue (27%), flank pain (19%), urinary tract infection (12%), sepsis (8%) and haematuria (8%). No patients had impaired renal function during follow-up and there were no treatment-related deaths. Seventeen patients (59%) had no evidence of disease at PDE and have not experienced recurrence at a median follow-up of 13.0 months post induction. ConclusionsAdministration of mitomycin gel via a PCNT offers a low rate of ureteric stenosis, demonstrates a favourable safety profile, and is administered without general anaesthesia.

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Antegrade Instillation of UGN-101 (Mitomycin for Pyelocalyceal Solution) for Low-Grade Upper Tract Urothelial Carcinoma: Initial Clinical Experience

Cited by 15 publications

References 20 publications

Treatment of Low-grade Intermediate-risk Nonmuscle-invasive Bladder Cancer With UGN-102 ± Transurethral Resection of Bladder Tumor Compared to Transurethral Resection of Bladder Tumor Monotherapy: A Randomized, Controlled, Phase 3 Trial (ATLAS)

Treatment of Low-grade Intermediate-risk Nonmuscle-invasive Bladder Cancer With UGN-102 ± Transurethral Resection of Bladder Tumor Compared to Transurethral Resection of Bladder Tumor Monotherapy: A Randomized, Controlled, Phase 3 Trial (ATLAS)

New technologies for nephron-sparing surgery in upper urinary tract cancers

Antegrade administration of mitomycin gel for upper tract urothelial carcinoma via percutaneous nephrostomy tube: a multi‐institutional retrospective cohort study

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