Is it a case for chemoablation?
These potential JELMYTO candidates present with a range of characteristics and histories.
Does RNU have to be the next step for Ted’s unresectable primary disease?
Ted, 55
Newly diagnosed, primary diseaseNot an actual patient.Ted, 55 years old, reported hematuria and flank pain. Urinalysis ruled out urinary tract infection. Cytoscopy ruled out bladder cancer.
Retrograde urography showed a large filling defect, and CT scan showed 2 endoscopically unresectable papillary tumors in the lower pole of the left renal pelvis. Ureteropyeloscopy and biopsy confirmed low-grade UTUC.
Father of 2 school-aged children, Ted is scared to lose a kidney. He prefers a noninvasive procedure that will not require extensive recovery.
- Key treatment considerations:
- 2 kidneys
- 2 unresectable papillary tumors
- Diameter of largest tumor: 15 mm
- Comorbidities: Hypertension
- Treatment site: ASC
Is endoscopic management the most comprehensive approach for Sidney’s recurrent disease?
Sidney, 71
Recurrent, endoscopically managedNot an actual patient.Sidney, a 71-year-old veteran, was treated with laser ablation for a low-grade papillary tumor in her left renal pelvis last year.
Four months ago, she reported flank pain on her left side. CT urogram showed a 12 mm and 5 mm papillary lesion in the mid-pole calyx of her left renal pelvis and a 0.5 mm ureteral tumor. A diagnostic ureteroscopy was performed and biopsy confirmed recurrence of low-grade UTUC.
Sidney has tried laser ablation before but has asked what else can be done to support a durable treatment response.
- Key treatment considerations:
- 2 kidneys
- 3 resectable papillary tumors
- Diameter of largest tumor: 15 mm
- Comorbidities: Hyperlipidemia, obesity
- Treatment site: Clinic
What is the next step for Mia, whose advanced age and comorbidities make treatment challenging?
Mia, 76
Recurrent, comorbiditiesNot an actual patient.Mia is a 76-year-old grandmother with chronic kidney disease and a history of bladder cancer.
One year after endoscopic treatment, Mia had a recurrence in the upper tract with a low-grade papillary tumor of 3 mm in the upper pole calyx of her left kidney. She was treated with ablation but developed postoperative vomiting from general anesthesia and a painful urinary tract infection.
Within 8 months, Mia’s CT scan showed a new, low-grade, resectable papillary tumor in the mid-portion of her right kidney.
With her age and comorbid conditions, RNU could put her future health at risk.2
- Key treatment considerations:
- 2 kidneys
- 1 resectable papillary tumor
- Diameter of tumor: 12 mm
- Comorbidities: CKD, hyperlipidemia
- Treatment site: Hospital
*Jelmyto is instilled via the pyelocalyceal system in a procedure that spares the kidney.
CKD=chronic kidney disease; CT=computerized tomography; RNU=radical nephroureterectomy.
Is a bilateral patient like Jonathan a candidate for chemoablation with Jelmyto?
Jonathan, 67
Bilateral diseaseNot an actual patient.Jonathan is 67 years old and newly retired. Two years ago, he was treated with endoscopic ablation for low-grade UTUC in his right kidney.
A recent MRI urogram demonstrated an enhancing soft tissue lesion in the right upper pole calyx and 3 smaller tumors throughout the renal pelvis of his left kidney. Two of these low-grade tumors were endoscopically unresectable.
Jonathan’s right kidney is currently being treated with ablation. He needs a treatment that can effectively address the unresectable tumors in his left kidney while taking both renal risk and upcoming travel plans into account.2
- Key treatment considerations:
- 2 kidneys
- > 3 papillary tumors, 2 unresectable
- Diameter of tumor: 12 mm
- Comorbidities: Hypertension
- Treatment site: Clinic
Does RNU have to be the next step for Ted’s unresectable primary disease?
Not an actual patient.Ted, 55 years old, reported hematuria and flank pain. Urinalysis ruled out urinary tract infection. Cytoscopy ruled out bladder cancer.
Retrograde urography showed a large filling defect, and CT scan showed 2 endoscopically unresectable papillary tumors in the lower pole of the left renal pelvis. Ureteropyeloscopy and biopsy confirmed low-grade UTUC.
Father of 2 school-aged children, Ted is scared to lose a kidney. He prefers a noninvasive procedure that will not require extensive recovery.
- Key treatment considerations:
- 2 kidneys
- 2 unresectable papillary tumors
- Diameter of largest tumor: 15 mm
- Comorbidities: Hypertension
- Treatment site: ASC
