|The following article features coverage from the American Urological Association (AUA) 2019 meeting. Click here to read more of Renal & Urology News’ conference coverage.|
CHICAGO—Neoadjuvant chemotherapy (NAC) prior to nephroureterectomy for high-grade upper tract urothelial carcinoma (UTUC) has the potential to offer a survival advantage, investigators reported at the 2019 American Urological Association annual meeting.
In a multicenter, prospective phase 2 trial, Jonathan A. Coleman, MD, of Memorial Sloan Kettering Cancer Center in New York, and colleagues recruited 55 patients with high-risk localized UTUC as of January 2019. Patients received NAC with 4 cycles of gemcitabine and cisplatin (GC) prior to planned nephroureterectomy or distal ureterectomy. The primary outcome was pathologic response rate.
At the time of analysis, evaluable pathologic findings were available for 48 patients. Of these, 28 (58%) had pathologic response, defined as achieving less than pT2N0 disease, with 9 patients (19%) achieving pT0N0 disease. Forty (85%) of the 48 patients tolerated all 4 GC cycles.
With a median follow-up of 2.6 years among survivors, 6 patients died from their disease. The 2-year overall survival rate was 89%. Patients who had a pathologic response had a significantly higher 2-year survival rate than those who did not (100% vs 74%). The 90-day grade 3 or higher complication rate was 6.2%.
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Coleman JA, Wong NC, Sjoberg DD, et al. Multicenter prospecteive phase II clinical trial of gemcitabine and cisplatin as neoadjuvant chemotherapy in patients with high-grade upper tract urothelial carcinoma. Presented at the 2019 American Urological Association annual meeting held May 3-6 in Chicago. Abstract LBA-17.