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Recent Findings from Clinical Trials, Observational Studies, and Molecular and Genomic Research in Upper Tract Urothelial Carcinoma

Sam Chang | July 05, 2022

Thank you for visiting UroToday’s Center of Excellence on upper tract urothelial carcinoma (UTUC). We examine expert content in a variety of formats to help practicing clinicians stay up to date. This letter highlights some of the most exciting recent findings from clinical trials, observational studies, and molecular and genomic research.

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Sam S. Chang, MD, MBA, Patricia and Rodes Hart Endowed Professor of Urologic Surgery and Oncology, is the Oncology Fellowship Director and Vice-Chair of Urologic Surgery at Vanderbilt University Medical Center. His clinical practice focuses on urologic oncology and he has led numerous guideline panels in prostate, bladder and kidney cancer and formerly chaired the American Joint Committee on Cancer GU Staging Task Force. Author of more than 275 articles and recipient of multiple awards such as the SUO’s first-ever Distinguished Service Award, a CaPCURE Prostate Cancer Young Investigator Award, multiple Journal of Urology Best Reviewer, and the AUA Gold Cystoscope Award, he currently serves as Assistant Secretary of the AUA.

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Clinical Conversations by Experts
Study Shows Bladder Cuff Excision Improves Recurrence-Free Survival After Nephroureterectomy - Courtney Yong & Chandru Sundaram
EV-302 Trial Establishes Treatment Standard for Urothelial Carcinoma - Daniel Petrylak
UGN-101 in Upper Tract Urothelial Cancer: Real-World Data Analysis - Joseph Jacob
Early Bladder Recurrence Common in UTUC Patients Post-Nephroureterectomy Despite BCG Treatment - Paul Crispen
FGFR3 Inhibition for Upper Tract Urothelial Cancer: Phase 1b Trial Results - Surena Matin
ENLIGHTED Trial Advances Upper Tract Urothelial Cancer Treatment - Vitaly Margulis
Advancing UTUC Diagnosis: Protein-Based Biomarker Test Outperforms Cytology - Hideki Furuya
POUT Trial: Final Results of Adjuvant Chemotherapy in Upper Tract Urothelial Carcinoma - Alison Birtle
Predictive Biomarkers for Upper Tract Urothelial Carcinoma - Helen Hougen
Route of Administration for UGN-101 and the Impact on Oncological & Safety Outcomes - Jennifer Linehan
What Every Urologist Should Know About UGN-101 Treatment and its Real-World Implications for Urothelial Cancer - Hristos Kaimakliotis
Guidelines and Real-World Scenarios in Upper Tract Urothelial Carcinoma Treatment - Kyle Rose
Management of Low-Grade Upper Tract Urothelial Carcinoma: Case-Based Presentation - Rashid Sayyid
Comprehensive Geriatric Assessments in Urologic Cancer Care: Identifying Modifiable Risk Factors for Personalized Treatment - Sarah Psutka
Overcoming Upper Tract Urothelial Carcinoma: Michael Miller's Journey with JELMYTO® Treatment - Michael Miller
Choosing JELMYTO®: A Patient's Journey Through Less Invasive Upper Tract Urothelial Carcinoma Treatment - Tom Murphy
Final Results of a Phase I Trial of WST-11 (TOOKAD Soluble) Vascular-targeted Photodynamic Therapy for Upper Tract Urothelial Carcinoma - Wesley Yip and Jonathan Coleman
Results from the Radical Nephroureterectomy Outcomes (RaNeO) Registry - Clara Cerrato
Establishing a Workable Treatment Algorithm for JELMYTO® for Low-Grade Upper Tract Urothelial Carcinoma- Amy Luckenbaugh
JELMYTO® Treatment for Upper Tract Urothelial Carcinoma and Lynch Syndrome: Patient Journey and Innovative Therapy - Michael Miller
AUA Guidelines for Upper Tract Urothelial Carcinoma: Streamlined Approaches and Novel Opportunities for Treatment - Jean Heather Hoffman-Censits
Insights into the AUA Guidelines for Upper Tract Urothelial Carcinoma: Standardizing Diagnosis and Treatment for Better Patient Outcomes - Jonathan A. Coleman
Expert Panel Discussion on Management of UTUC: Insights on Treatment, Prevention, and Future Directions - Surena Matin, Jay Raman, Sima Porten, and Tomonori Habuchi
Game-Changing Trial Targets Immunotherapy for UTUC - Woodson Smelser
Charting New Paths in Urothelial Cancer Treatment: the ECOG-ACRIN 8192 Trial - Jean Hoffman-Censits
Longitudinal GFR Trends After Neoadjuvant Chemotherapy Prior to Nephroureterectomy for Upper Tract Urothelial Carcinoma - Surena Matin & Craig Labbate
Practice Changing Abstracts in Upper Tract Urothelial Carcinoma, A Review from the 2022 AUA - Firas Petros
A Multidisciplinary Approach to Treating High-Grade Upper Tract Disease - A Case-Based Approach - Surena Matin, Jonathan Coleman, and Jean Hoffman-Censits
Antegrade Administration of Reverse Thermal Mitomycin Gel for Primary Chemoablation of Upper Tract Urothelial Carcinoma via Percutaneous Nephrostomy Tube - Katie Murray
Evaluating the Impact of Variant Histology Pathologic Diagnosis on Survival Outcomes in Patients with Upper Tract Urothelial Carcinoma - Wesley Yip
Upper Tract Urothelial Carcinoma Highlights - Nima Almassi
Durability of Response to Primary Chemoablation of Low-Grade Upper Tract Urothelial Carcinoma Using UGN-101 in the OLYMPUS Trial - John Gore
Comparative Effectiveness of Neoadjuvant Chemotherapy In Bladder And Upper Urinary Tract Urothelial Carcinoma - Jeffrey Holzbeierlein
Real-World Experience on the Safety Efficacy of Antegrade Administration of JELMYTO® for UTUC via Percutaneous Nephrostomy Tube - Kyle Rose
A Growing Understanding and Multidisciplinary Approach to Treating Upper Tract Urothelial Carcinoma - Jeannie Hoffman-Censits
Long-Term Safety and Durability to Non-Surgical Treatment Instillation of UGN-101, Mitomycin-Containing Reverse Thermal Gel for Low-Grade Upper Tract Urothelial Carcinoma, Journal Club - Zachary Klaassen and Christopher Wallis
Gemcitabine and Cisplatin as Neoadjuvant Chemotherapy in Patients with High-Grade Upper Tract Urothelial Carcinoma - Wesley Yip
Endoscopy in the Setting of Low-Grade Upper Tract Urothelial Carcinoma A Lecture and Discussion - Surena Matin
Molecular Biomarkers in Upper-Tract Urothelial Carcinoma - Janet Kukreja
Treatment and Survival Differences in Patients With Urothelial Vs. Nonurothelial Bladder & Upper Tract Carcinomas - Jeanny Aragon-Ching
How I Treat Low-Risk Upper Tract Urothelial Carcinoma - Katie Murray
Radical Nephroureterectomy in Upper Tract Urothelial Cancer - Phillip Pierorazio
Antegrade Endoscopic Upper Tract Approaches - Ryan Hsi
Upper Tract Urothelial Carcinoma - Clinical Case Management in High-Risk Disease - Sima Porten
The POUT Trial's Impact on Upper Tract Urothelial Carcinoma: A Deep Dive into Adjuvant Chemotherapy - Evanguelos Xylinas
Risk Stratification of Upper Tract Urothelial Carcinoma - Doug Scherr
Genetics in Upper Tract Urothelial Cancer, What Urologists Should Know – Eugene J. Pietzak
Management and Challenges of Low Grade Upper Tract Urothelial Carcinoma - Surena Matin
Treatment Considerations for Upper Tract Urothelial Carcinoma - Eugene Pietzak and Arjun Balar
How I Use Jelmyto™ - Karim Chamie
Upper Tract Urothelial Carcinoma - Clinical Case Management – Jonathan Coleman
The Potential of Breakthrough Trials in Urothelial Carcinoma: ECOG-ACRIN 8192 - Petros Grivas
A Brief History of POUT & Three-year Updated Outcomes from A Phase III Randomized Trial of Peri-Operative Chemotherapy Vs. Surveillance in UTUC - Alison Birtle
Primary Chemoablation for the Treatment of Low-Grade Upper Tract Urothelial Carcinoma: The OLYMPUS Trial - Seth Lerner
Lancet Oncology OLYMPUS Trial Review: Primary Chemoablation for the Treatment of Low Grade Upper Tract Urothelial Carcinoma
Journal Club: The Efficacy and Safety of MitoGel™ (UGN-101) on Ablation of Upper Urinary Tract Urothelial Carcinoma (OLYMPUS) - Zachary Klaassen
Neoadjuvant Vs. Adjuvant Chemotherapy in Upper Tract Urothelial Carcinoma - Alison Birtle & Surena Matin
Developments in Treatment Options for Localized and Advanced Upper Tract Disease - Vitaly Margulis
The OLYMPUS Study: Mitomycin Gel for Low-grade Upper Tract Urothelial Cancer - Seth Lerner
The Impact of Treatment Delays of Upper Tract Urothelial Carcinoma (UTUC) During the COVID-19 Pandemic Journal Club - Zachary Klaassen
Moving the Field Forward, Upper Tract Urothelial Carcinoma, The POUT Study - Alison Birtle
Biology and Genomic Distinctions in Metastatic Urothelial Carcinoma and Upper Tract Urothelial Cancers - Andrew Hsieh - Bishoy Faltas - Matthew Galsky
SAUL Trial Data: Real World Experience of Atezolizumab in Carcinomas of the Urinary Tract- Cora Sternberg
Systemic Therapies in Upper Tract Urothelial Carcinoma - Srikala Sridhar
Challenges in the Diagnosis and Treatment of UTUC - Peter Black
Challenges in Immunotherapy for Bladder Cancer- Maria De Santis
The Diagnostic and Therapeutic Challenges Associated with UTUC - Sam Chang
Physician-Scientist Review Articles
State of the Evidence Review Articles
Written by Rashid K. Sayyid, MD, MSc, and Zachary Klaassen, MD, MSc
March 20, 2023
Urothelial carcinoma of the upper tract accounts for only five to ten percent of all urothelial carcinomas,1 with an estimated annual incidence in Western countries of almost two cases per 100,000 inhabitants.2
Written by Zachary Klaassen, MD, MSc
April 13, 2021
Upper tract urothelial carcinoma (UTUC) is a rare malignancy with an incidence of 1 case per 50,000 people in developed countries. Because symptoms are often non-specific, there are delays in presentation and diagnosis and, as a result, more than half of patients present with muscle-invasive or locally advanced disease.
Written by Christopher J.D. Wallis, MD, PhD and Zachary Klaassen, MD, MSc
May 20, 2020
While radical nephroureterectomy remains the gold standard treatment for patients with UTUC, this approach may not be suitable for some patients and for some tumors. More recently, the topical treatment of patients with UTUC advanced with the FDA approval of mitomycin (JELMYTO™). Results from the OLYMPUS Phase III study represent the first agent specifically approved for

 

Written by Zachary Klaassen, MD, MSc
May 1, 2020
Over the last several months, the diagnosis, treatment, and surveillance of genitourinary malignancies has been transformed by the global COVID-19 pandemic. The heavy demand for resources, exacerbated by limited excess health system capacity, means that health care systems have become quickly overwhelmed and hospitals have become sources for virus transmission.
Written by Zachary Klaassen, MD, MSc
April 15, 2020

Upper tract urothelial carcinoma, which may affect the renal pelvis or ureter, is a relatively rare disease, accounting for less than 10% of all urothelial carcinomas. In parallel to how we view urothelial carcinoma of the bladder, the risk of recurrence and progression from upper tract urothelial carcinoma depends on tumor grade and stage. 

Written by Zachary Klaassen, MD, MSc
December 10, 2019
The urothelium lines the urinary tract from the renal pelvis to urethra. While cancers may arise anywhere along the urothelium, the vast majority (90-95%) occur in the lower urinary tract (bladder and urethra) while the remainder (5-10%) occur in the upper tract (ureter and renal pelvis)1.
Written by Zachary Klaassen, MD, MSc
April 15, 2019
Upper tract urothelial carcinoma, comprising either the renal pelvis or ureter, is rarer than urothelial carcinoma of the bladder accounting for only 5-10% of all urothelial carcinomas. However, similar to bladder urothelial carcinoma,
January 29, 2019
Upper tract urothelial carcinoma (UTUC) comprises any malignancies arising from the urothelium between the level of the renal pelvis and the distal ureter. Owing to their relatively rarity, there is generally little data to guide the management of patients with these tumors and much of practice is extrapolated from the management of urothelial cancer of the bladder.
Physician-Scientist Commentaries
Peer-reviewed Abstract Supplemental Commentaries
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine
Upper tract urothelial carcinoma (UTUC) represents 5% of urothelial cancers, yet it can be highly aggressive and associated with poor prognosis. The standard of care is radical nephroureterectomy (RNU) with bladder cuff resection and perioperative chemotherapy. However, surgery carries risks and complications
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine
Hematuria is a common symptom with various possible causes, including upper tract (UT) urothelial malignancy. Approximately 3% of microhematuria (MH) cases are associated with genitourinary malignancies. The American Urological Association updated guidelines in 2020 recommend risk-stratification for UT imaging to balance diagnostic benefits with discomfort, cost, and radiation exposure.
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine
Detection of upper tract carcinoma in situ (UTcis) is challenging. There is a growing interest in effective renal-sparing treatment options for these patients. Instillation of Bacillus Calmette-Guérin (BCG) has proven effective in bladder carcinoma in situ, and a few studies have reported its use in patients with UTcis. Fontanet et al. studied BCG treatment in patients with UTcis and a systematic review of previous literature.
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine
UGN-101, or Jelmyto, is a mitomycin-based hydrogel approved for low-grade upper tract urothelial carcinoma chemoablation. Clinical trials demonstrated that 59% of patients on UGN-101 treatment had a complete response, of whom more than 80% experienced long-term response. UGN-101 can be administered via an anterograde or retrograde route, but there is a lack of studies comparing the outcomes across the two administration routes.
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine
Aristolochic acid is a potent nephrotoxin and carcinogen found in ‘slimming’ herbal remedies associated with urothelial cancer and renal failure. Although it was then banned in many countries, the incidence of upper urinary tract urothelial carcinoma continued to increase for years after exposure.
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine
Upper tract urothelial carcinoma (UTUC) is a rare form of urothelial cancer associated with a metastasis rate of 12-16% at the time of diagnosis. Due to the low incidence of UTUC, few studies have investigated predictors of metastatic UTUC. Hu et al. examined factors associated with metastatic UTUC and surgical outcomes among patients.
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine
Radical nephroureterectomy (RNU) is a standard of care for treating localized upper tract urothelial carcinoma (UTUC). Laparoscopic RNU (LRNU) is a minimally invasive procedure. Since UTUC mainly affects elderly patients, Koterazawa et al. aimed to characterize outcomes among octogenarians who underwent LRNU.
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine, New York City, New York
The value of Lymph Node Dissection during radical nephroureterectomy for patients with upper tract urothelial carcinoma is unclear. Xia et al. analyzed the impact of lymph node dissection on survival outcomes in patients with upper tract urothelial cancer.
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine, New York City, New York
Patients with upper tract urothelial carcinoma (UTUC) can be divided into low-risk or high-risk groups. Surveillance recommendations for patients with high-risk UTUC are extrapolated from those used in bladder cancer. Martini et al. aimed to refine surveillance recommendations specific to UTUC.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
The definitive treatment for high-grade localized upper tract urothelial carcinoma (UTUC) is radical nephroureterectomy (RNU). Neoadjuvant pembrolizumab was tested in patients with muscle-invasive bladder cancer before radical cystectomy and demonstrated promising efficacy in the PURE-01 trial.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Gross hematuria is a distressing symptom for patients with upper urinary tract urothelial cancers (UTUC). Invasive procedures are usually employed to control hematuria, including surgical resection, endoscopic laser ablation, and percutaneous nephroscopic resection.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Upper urinary tract urothelial carcinoma (UTUC) arises from the renal pelvicalyceal system and ureters and accounts for 5–10% of all urothelial carcinomas. After definitive UTUC treatment by radical nephroureterectomy with bladder cuff excision (RNU)
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Upper urinary tract urothelial carcinoma (UTUC) constituted 5-10% of urothelial carcinomas. The management of UTUC has significantly changed in the last decade with the introduction of neoadjuvant chemotherapy options and kidney-sparing surgery (KSS)
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine
Arsenic exposure is associated with a higher risk of developing urothelial carcinoma (UC). Previous studies mostly focused on UC of the bladder.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Upper tract urothelial (UTUC) is an uncommon malignancy. Defining the impact of adjuvant chemotherapy on long term outcomes in UTUC patients is a critical clinical question. Recently, Birtle et al. reported
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Defining the prognosis of patients who develop intravesical recurrence (IVR) after radical nephroureterectomy (RNU) is critical for the optimal management of these patients.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Intravesical recurrence (IVR) rates remain high in urothelial carcinoma of the upper urinary tract (UTUC) patients following radical nephroureterectomy
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Lynch syndrome (LS), caused by a mutation in the mismatch repair (MMR) genes (MLH1, MSH2, MSH6, PMS2). LS increases the individual’s risk of getting upper urinary tract urothelial carcinoma (UTUC).
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Although urothelial carcinomas of the bladder and upper tract urothelial carcinoma (UTUC) can have similar histology, they significantly differ in prevalence and risk factors.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Upper tract urothelial carcinoma (UTUC) is a distinct clinical entity with poor clinical outcomes.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Lynch Syndrome (LS) is a common hereditary cancer syndrome that is characterized by mutations in the mismatch repair (MMR) genes.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Circulating tumor cells (CTCs) are cancer cells shed from the tumor that enter the circulation.
Written by Bishoy M. Faltas, MD
Englander Institute for Precision Medicine, Weill Cornell Medicine
Upper tract urothelial carcinoma is less common than bladder urothelial carcinoma. The biological characteristics of this form of the disease is not completely understood.
Conference Coverage
Conference Highlights Written by Physician-Scientist
Presented by Saad Sabbagh, MD
The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a bladder cancer session and a presentation by Dr. Saad Sabbagh discussing a national analysis evaluating the role of lymph node dissection in patients with high-risk upper tract urothelial carcinoma.
Presented by Craig Labbate, MD
The 2023 American Urological Association (AUA) annual meeting held in Chicago, was host to an upper tract transitional cell carcinoma podium session. Dr. Craig Labbate presented the results of a study analyzing the efficacy and safety of mitomycin gel (UGN-101) as adjuvant therapy following complete endoscopic management of upper tract urothelial carcinoma (UTUC).
Presented by Jennifer A. Linehan, MD & Sandip M. Prasad, MD, MPHil
The 2023 American Urological Association (AUA) annual meeting held in Chicago, IL between April 28 and May 1st, 2023, was host to a Product Theater in the Square session, sponsored by UroGen® Pharma. Drs. Jennifer Linehan and Sandip Prasad discussed the utility, efficacy, and safety of JELMYTO across low-grade upper tract urothelial carcinoma (UTUC) presentations and practice patterns, using adaptable patient and physician-centered approaches.
Presented by Surena Matin, MD
The 2023 American Urological Association (AUA) annual meeting held in Chicago, IL between April 28 and May 1st, 2023, was host to a plenary session that included a panel discussion for the management of upper tract urothelial carcinoma (UTUC). This discussion was moderated by Dr. Surena Matin, and included Drs. Jay Raman, Tomonori Habuchi, and Sima Porten as panelists.
Presented by Jonathan A. Coleman, MD
The 2023 American Urological Association (AUA) annual meeting held in Chicago, IL between April 28 and May 1st, 2023, was host to a plenary session, with Dr. Jonathan Coleman presenting the first iteration of the AUA/SUO guidelines for the diagnosis and management of non-metastatic upper tract urothelial carcinoma (UTUC).
Presented by Maria De Santis, MD, PhD
The 2023 EAU annual meeting included an EAU guideline session on effective treatment in upper tract urothelial tumors, featuring a state-of-the-art presentation by Dr. Maria De Santis discussing immunotherapy in locally advanced and metastatic upper tract urothelial carcinoma.
Presented by Thomas Seisen, MD
The 2023 EAU annual meeting included an EAU guideline session on effective treatment in upper tract urothelial tumors, featuring a state-of-the-art presentation by Dr. Thomas Seisen discussing the evidence for neoadjuvant treatment before radical nephroureterectomy.
Presented by Joyce Baard, MD
The 2023 EAU annual meeting included an EAU guideline session on effective treatment in upper tract urothelial tumors, featuring a state-of-the-art presentation by Dr. Joyce Baard discussing improvement in technologies and drugs to support kidney sparing surgery.
Presented by Alison J. Birtle, MD
The 2023 EAU annual meeting included an EAU guideline session on effective treatment in upper tract urothelial tumors, featuring a state-of-the-art presentation by Dr. Alison Birtle discussing the role of systemic chemotherapy after radical nephroureterectomy.
Presented by Phillip M. Pierorazio, MD
The poster session focusing on Bladder and Kidney cancer was held at the Annual Meeting of the Society of Urologic Oncology. In this session, Dr. Phillip M. Pierorazio presented long-term outcomes for patients treated with UGN-101 for low-grade upper tract urothelial carcinoma (UTUC).
Presented by Josh Gottlieb, DO
A poster session focusing on Bladder and Kidney cancer was held at the Annual Meeting of the Society of Urologic Oncology and in this session, Dr. Josh Gottlieb presented results of a multi-center study examining alternative routes of administration for UGN-101.
Presented by Jacob Taylor MD, MPH
A poster session focusing on Bladder and Kidney cancer took place at the Annual Meeting of the Society of Urologic Oncology and in this session, Dr. Jacob Taylor presented the results of a multi-center study examining the early clinical experience with the use of UGN-101.
Presented by Ashish M. Kamat, MD, MBBS
The 37th Annual European Association of Urology Congress held in Amsterdam, Netherlands between July 1st, and 4th 2022 was host to a plenary session on perioperative treatment of urothelial cancers in 2022. Dr. Ashish Kamat expertly discussed the landscape of current trials with intravesical treatment in high-risk BCG naïve non-muscle invasive bladder cancer (NMIBC).
Presented by Angela Smith, MD, MS
The 2022 Annual Meeting of the American Urological Association was host to a moderated poster session for non-invasive bladder cancer. Dr. Smith presented the health-related quality of life outcomes results for low-grade non-muscle invasive bladder cancer (LG NMIBC) patients receiving UGN-102, a mitomycin containing reverse thermal gel.
Presented by Andrew Stemberger
The 2022 Annual Meeting of the American Urological Association was host to a moderated poster session for non-invasive bladder cancer. Dr. Andrew Stemberger presented the 2-year follow up results of BCG-unresponsive NMIBC patients treated with hyperthermic Mitomycin C.
Presented by Kyle Rose, MD
The 2022 Annual Meeting of the American Urological Association was host to a podium presentation by Dr. Kyle Rose from Moffitt Cancer Center who presented real-world data on the antegrade administration of reverse thermal mitomycin (JEMLYTO®) for primary chemoablation of upper tract urothelial carcinoma (UTUC) via a percutaneous nephrostomy tube.
Presented by Jennifer A. Linehan, MD

The 2022 Annual Meeting of the American Urological Association was host to an exhibition hosted by UroGen® and presented by Dr. Jennifer Linehan. Dr. Linehan began her presentation by highlighting that the long-term standard of care has delivered suboptimal outcomes for low-grade upper tract urothelial cancer (LG-UTUC) patients.

 

Presented by Surena F. Matin, MD
In a podium presentation in the Late-Breaking Abstracts session at the 2022 American Urologic Association Annual Meeting held in New Orleans and virtually, Dr. Matin presented the results of a phase Ib trial assessing the tolerability and activity of FGFR inhibition in patients with localized upper tract urothelial carcinoma (UTUC)
Presented by Sima Porten, MD, MPH
The 2022 American Urological Association (AUA) Annual Meeting included the Society of Urologic Oncology (SUO) session and a presentation by Dr. Sima Porten discussing adjuvant therapy after nephroureterectomy for high-risk upper tract urothelial carcinoma.
Presented by Douglas Schneider,
The Engineering and Urology Society included a poster session featuring work from Douglas Schneider and colleagues presenting results of their study assessing thulium laser lithotripsy augmented with a novel reverse thermal hydrogel (Hydrogel) developed by UroGen Pharma in an in-vivo porcine model. \
Presented by Christian Ericson, MD
The 2022 Southeastern Section of the AUA’s annual meeting included a bladder cancer session and Dr. Christian Ericson discussing whether metachronous bladder tumors are predictive of upper tract urothelial carcinoma recurrence in patients treated with radical or endoscopic surgery.
Presented by Surena F. Matin, MD
(UroToday.com) The 2022 GU ASCO Annual featured a presentation by Dr. Surena Matin discussing endoscopic management of low-grade upper tract urothelial carcinoma. Dr. Matin notes that there are several challenges to the management of low-grade upper tract urothelial carcinoma.
Presented by Hong Truong, MD MS
The hereditary cancer syndrome Lynch syndrome, molecularly characterized by loss of MLH1, MSH2, MSH6, PMS2) or the EPCAM genes, causes a variety of cancers. Dr. Truong highlights that colorectal and endometrial cancers are the two most common Lynch syndrome-associated cancers with established guidelines for molecular testing. 
Presented by Jonathan Coleman, MD
The SUO 2021 annual meeting in Orlando, FL included an overview of molecular classification of upper tract urothelial carcinoma (UTUC), presented by Dr. Jonathan Coleman, MD, Associate Professor at the Memorial Sloan Kettering Cancer Center in New York, NY.
Presented by Alison J. Birtle, MD, MBBS, MRCP, FRCR, BSc
In a session entitled Clearer Vision chaired by Dr. Bertrand Tombal at the 2021 ANZUP Annual Scientific Meeting, Dr. Alison Birtle discussed what she described as wishful thinking in genitourinary oncology, with a focus on optimal therapy for systemic therapy in upper tract urothelial carcinoma (UTUC).
Presented by Karim Chamie, MD
The AUA 2021 virtual annual meeting included a late-breaking abstract session with a presentation by Dr. Karim Chamie discussing long-term recurrence free survival following UGN-101 treatment for low-grade upper tract urothelial carcinoma.
Presented by Jennifer Linehan, MD
In this study by Linehan and colleagues, the authors focus on the outcomes of female patients from the OLYMPUS trial [NCT02793128], in which patients with low grade upper tract urothelial carcinoma (LG-UTUC) were treated with a novel reverse thermal gel containing mitomycin.
Presented by William Huang, MD
Most patients newly diagnosed with bladder cancer have non-muscle invasive disease (NMIBC). For patients with intermediate or high-risk NMIBC and those with carcinoma in situ (CIS), adjuvant treatment with BCG is guideline-recommended on the basis of proven benefits in disease recurrence.
Presented by Surena F. Matin, MD
The 2021 American Urological Association (AUA) Summer School session on Upper Tract Urothelial Carcinoma included a case-based discussion led by moderator Dr. Surena Matin who was joined by panelists Dr. Sima Porten and Dr. Vitaly Margulis.
Presented by Nadine Houede, PhD
The Controversies in Onco-Urology session at the EAU 2021 annual meeting included a presentation by Dr. Nadine Houede who discussed the adjuvant approach to the optimal timing of perioperative systemic therapy for high-risk upper tract urothelial carcinoma.
Presented by Yasuyoshi Miyata, MD, Ph.D
Yasuyoshi Miyata from Japan presented results of a randomized clinical trial of intravesical mitomycin C plus cytarabine (Ara-C) versus mitomycin C for patients with non-muscle invasive bladder cancer (NMIBC) at the European Association of Urology 2021 annual meeting.
Presented by Arnulf Stenzl, MD
The Urology Beyond Europe thematic sessions included the Joint Session of the European Association of Urology (EAU) and the Arab Association of Urology, as well as a presentation by Dr. Arnulf Stenzl discussing established treatment and guidelines for upper tract urothelial carcinoma.
Presented by Morgan Roupret, MD, PhD
The joint session of the European Association of Urology (EAU) and the Japanese Urological Association at the 2021 EAU virtual annual meeting included a presentation by Dr. Morgan Roupret highlighting the updated guidelines on the management of upper tract urothelial carcinoma. This update was published in 2020 in European Urology.1
Presented by Bishoy M. Faltas, MD
Most patients newly diagnosed with bladder cancer have non-muscle invasive disease (NMIBC). For patients with intermediate or high-risk NMIBC and those with carcinoma in situ (CIS), adjuvant treatment with BCG is guideline-recommended on the basis of proven benefits in disease recurrence.
Presented by Alison J. Birtle, MD, MBBS, MRCP, FRCR, BSc
The POUT trial (CRUK/11/027; NCT01993979) previously reported that adjuvant chemotherapy improves disease free survival (HR 0.45, 95% CI 0.30-0.68) for patients with histologically confirmed pT2-T4 N0-3 M0 upper tract urothelial carcinoma over a median follow-up of 30.3 months.1
Presented by Jen-Jane Liu, MD
Neoadjuvant chemotherapy (NAC) is the standard of care for muscle-invasive bladder cancer.  However, upper tract urothelial carcinoma (UTUC) is not the same as bladder cancer, with a higher rate of invasive disease.
Presented by Surena F. Matin, MD
Dr. Surena Matin presented the final results of the OLYMPUS trial, Optimized DeLivery of Mitomycin for Primary UTUC Study (Olympus) at the Best of Bladder Cancer poster session.
Presented by Shahrokh F. Shariat, MD
At the European Multidisciplinary Congress on Urological Cancers (EMUC) 2020 virtual meeting, Dr. Shahrokh Shariat discussed the role of kidney sparing surgery for upper tract urothelial carcinoma. Dr. Shariat notes that radical nephroureterectomy is not the standard of care for all patients with upper tract urothelial carcinoma, in particular those with low-grade Ta tumors, as it has been estimated that 18-25% of patients may be over-treated (pT0, pTa, pTis) with radical nephroureterectomy.
Presented by Karim Chamie, MD
In a sponsored educational session at the American Urologic Association Virtual Annual Meeting, Karim Chamie, MD, presented on the recently expanded kidney-sparing options for patients with low-grade upper tract urothelial cancer.
Presented by Chana Weinstock, MD
Washington, DC (UroToday.com) The expert panel of providers and FDA discussed ongoing and future collaborations with the FDA and bladder cancer. The FDA Oncology Center of Excellence (OCE) leverages the combined skills of regulatory scientists and reviewers. The panel reviewed the structure of the OCE and how expedited programs within the FDA strive to accelerate drug development and approval.
Presented by Seth Lerner, MD, FACS
Chicago, IL (UroToday.com) Low grade upper tract urothelial carcinoma (LG UTUC) can be managed with endoscopic resection/ablation however, the associated high recurrence rate requires repetitive intervention and intercavitary therapy for the frequently recurrent and multifocal disease.
Presented by Srikala (Kala) Sridhar, MD, MSc, FRCPC
Barcelona, Spain (UroToday.com)  Dr. Kala Sridhar, a medical oncologist from the University of Toronto, provided a summary of the current status of chemotherapy for upper tract urothelial carcinoma (UTUC).  UTUC accounts for 5-10% of urothelial malignancies, of which 60% are invasive at disease presentation. Radical nephroureterectomy remains the standard of care for localized and invasive disease.
Presented by Juan Palou, MD, PhD
Barcelona, Spain (UroToday.com) Upper tract urothelial carcinoma (UTUC) is a rare condition, making large clinical trials difficult to accrue for. More importantly, known concerns with the accuracy of pre-operative staging, and therefore, difficulties in accurately identifying high-risk patients...
Presented by Morgan Roupret, MD, Ph.D
Barcelona, Spain (UroToday.com) Upper tract urothelial carcinoma (UTUC) is a rare condition, making large clinical trials difficult to accrue for. More importantly, known concerns with the accuracy of pre-operative staging, and therefore, difficulties in accurately identifying high-risk patients make clinical trial accrual and accuracy difficult. As such, much of the data for UTUC is often extrapolated
Presented by Seth Paul Lerner, MD, FACS
San Francisco, CA (UroToday.com) -- UroGen Pharma Ltd., a clinical-stage biopharmaceutical company developing treatments to address unmet needs in the field of urology, with a focus on uro-oncology,  announced a new data presentation from an interim analysis of the ongoing pivotal Phase 3 OLYMPUS clinical trial of UGN-101 (MitoGel™),
Presented by Alison J. Birtle, MD, MRCP, FRCR
San Francisco, CA (UroToday.com) The management of patients with upper tract urothelial carcinoma (UTUC) is challenging due to the lack of high-level evidence, which results from the disease’s overall rarity. The standard of care for patients with high-grade disease or those suspected to have invasive disease is a radical nephroureterectomy,

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Abstracts:
Upper Tract Urothelial Carcinoma
Center of Excellence:
Bladder Cancer
Center of Excellence:
Kidney Cancer