Andres F. Correa, MD
Fox Chase Cancer Center is offering a new treatment for patients with low-grade upper tract urothelial cancer (UTUC). Jelmyto® provides an effective, kidney-sparing option for this rare cancer that occurs in either the inner lining of the tube that connects the kidney to the bladder (the ureter) or within the inner lining of the kidney. Because of the anatomy of the kidney, low-grade UTUCs can be challenging to treat surgically and often recur.
“These are low-risk tumors that can keep coming back, and patients often grow tired of having to return for a resection every three months,” explained Andres F. Correa, MD, assistant professor in the Department of Surgical Oncology, Division of Urology and Urologic Oncology at Fox Chase. “The issue is, traditional chemotherapy does not stay in the kidney long enough to be effective; it runs out with urine.”
Jelmyto combines the drug mitomycin with a sterile, reverse thermal hydrogel that allows the medication to fill and conform to the patient’s anatomy. Jelmyto is chilled and administered as a liquid via a catheter. While a liquid, it fills and conforms to the anatomy of the renal pelvis. As Jelmyto warms, it forms a gel that coats even hard-to-reach tumors. Over the course of 4 to 6 hours, Jelmyto dissolves and is excreted via normal urine flow.
“This product will stay in the area around the tumor for almost six hours, allowing the medication to do its job for a longer period of time,” Dr. Correa said. phase-3 OLYMPUS trial studied the mitomycin-containing reverse thermal gel in patients with low-grade upper tract urothelial cancer and found that 58% of patients had a complete response at the primary disease evaluation visit.
The National Comprehensive Cancer Network (NCCN) recommends mitomycin gel be considered in patients who have had complete or near complete endoscopic resection or ablation. It is most appropriate for patients with solitary residual, low-grade, low-volume tumors who are not candidates or are not seeking removal of the kidney, ureter, and bladder cuff.
Fox Chase is the only academic center in the Philadelphia region and one of just a few practices offering this effective and convenient new treatment for patients. Jelmyto is an outpatient procedure. Patients receive Jelmyto once weekly for 6 weeks through a catheter. If a complete response is achieved, Jelmyto can be given once a month as maintenance therapy for an additional 11 months.
“For someone who has non-aggressive upper tract urothelial cancer and is considering kidney removal, this treatment could potentially spare them that procedure,” Dr. Correa said.