An investigational mitomycin formulation for the non-surgical treatment of low-grade upper tract urothelial cancer (LG-UTUC) is continuing to show promise. The latest data from the OLYMPUS Trial suggest that a minimally invasive chemoablation approach utilizing UGN-101, a novel reverse thermal hydrogel containing mitomycin, may result in a high rate of initial disease eradication, possibly obviating the need for kidney removal in select patients.
The findings, which were presented at the AUA annual meeting in Chicago, showed that 41 out of 68 patients (60%) for whom primary disease evaluation (PDE) data were available achieved a complete response after induction therapy. The authors found that 33 of the patients (48.5%) were initially characterized by the treating physician as having endoscopically unresectable tumor at baseline, and 19 patients (58%) achieved a complete response at the PDE.
“I believe UGN-101 has the potential to improve quality of life and lower morbidity by helping some patients avoid nephroureterectomy. Renal pelvis cancer typically presents in an elderly patient population with innately reduced kidney function, and UGN-101 would be an alternative to the potential morbidity of a major surgery, as well as the downstream deleterious effects from kidney removal,” said study investigator John L. Gore, MD, of the University of Washington in Seattle.
In the current analysis, only three of 41 patients who achieved a complete response had relapsed. One patient relapsed at 3 months following PDE, and two patients relapsed at 9 months. UGN-101 is designed to enable longer exposure of mitomycin to urinary tract tissue, and it is delivered using standard ureteral catheters. Currently, only 30% of UTUC patients receive endoscopic, nephron-sparing treatments.
The standard of care for endoscopically unresectable LG-UTUC is nephroureterectomy. However, this predisposes patients to renal insufficiency and increases the risk of requiring hemodialysis.
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