Urology Research & Practice
UROONCOLOGY - Systematic Review

Role of Chemoablation Using UGN-101 in Upper Tract Urothelial Carcinoma: A Systematic Review and MetaAnalysis of Available Evidence


Department of Urology, James Cook University Hospital, Middlesbrough, UK


Department of Urology, North Tees University Hospital, Stockton, UK


Department of Urology, Western General Hospital, Edinburgh, UK


Department of Urology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK


Department of Urology, University Hospitals Birmingham, Birmingham, UK

Urol Res Pract 2024; 50: 72-84
DOI: 10.5152/tud.2024.23215
Read: 190 Downloads: 131 Published: 16 April 2024

Objective: To examine the safety and efficacy of chemoablation using UGN-101 in patients with upper tract urothelial cancer (UTUC).

Methods: We conducted a systematic search through 7 databases/registries to identify key observational and experimental studies reporting either the efficacy or safety of UGN-101 in UTUC patients regardless of the risk or grade of the disease. The outcomes included efficacy (complete/partial/no response, survival, death, recurrence, or progression) and safety endpoints. All meta-analyses were conducted through STATA. The prevalence rate and its 95% CI were pooled across studies. A subgroup meta-analysis was conducted on follow-up. The quality was assessed using the Newcastle Ottawa Scale. Twenty studies (1051 patients) were analyzed.

Results: Complete response was reported in 49% (39%-60%) of cases, and 5% (0%- 15%) had disease progression. Treatment cessation was reported in 13% (3%-27%) of patients. Four percent of cases needed radical nephroureterectomy. Recurrence and death occurred in 14% (7%-23%) and 6% (2%-10%) of patients. Complications occurred in 63% (39%-85%), the majority of which were of grades I, II, and III. Ureteral stenosis was the most common complication accounting for 35% of cases. Chemoablationrelated complications occurred more than procedure-related ones. Based on available evidence, the intracavitary instillation of UGN-101 gel provides an alternative therapeutic option for upper tract urothelial cancer.

Conclusion: Chemoablation provides good clinical outcomes in terms of complete response, disease progression and recurrence, and the need to undergo nephroureterectomy. Complications were encountered in more than half the population; however, most of them were of low grades.

Cite this article as: Deb AA, Chitteti P, Naushad N, et al. Role of chemoablation using UGN-101 in upper tract urothelial carcinoma: A systematic review and meta-analysis of available evidence. Urol Res Pract. 2024;50(2):72-84.

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