Novel Adjuvant Therapies for Upper Tract Urothelial Carcinoma After Endoscopic Management

In highly selected patients with upper tract urothelial carcinoma, such as low-grade tumors, small lesions, solitary kidney, or bilateral disease, endoscopic management is a reasonable option although local recurrence rates are high during follow-up surveillance estimated at 30–70%. Adjuvant topical or systemic therapy after complete endoscopic ablation/resection presents an opportunity to minimize these recurrences while maintaining renal preservation and renal function long term. Although administration of these agents is sometimes challenging, robust data is available on the efficacy of these approaches including topical chemotherapy and checkpoint inhibition. We present a summary of findings that utilize novel, nontraditional agents as adjuvant therapy for upper tract urothelial carcinoma after endoscopic management over the last several years.