Do you plan to extrapolate from the NIAGARA trial regarding peri-operative durvalumab/cis/gem to treat upper tract urothelial carcinoma?

UTUC has different biology from MIBC and is considered more aggressive. Patients with UTUC were excluded from the NIAGARA, and therefore, we cannot make assumptions and extrapolations. Having said that, in patients with UTUC, it is important to check if they have microsatellite instability or Lynch ...

Currently, in my practice, I would not utilize NIAGARA data for patients with upper tract urothelial cancer. Patients with "primary non-bladder" cancers, i.e., those arising from the ureter, urethra, or renal pelvis, were excluded from the trial, even if they had urothelial histology.

There are also...

Currently, I am not using NIAGARA trial data for patients with upper tract urothelial carcinoma (since it was only for MIBC), but am very enthusiastic about the ongoing EA8192 phase II-III trial evaluating this critical question, details can be found in the link below (we highly encourage sites to o...

It is challenging to extrapolate the NIAGARA study data to the subset of patients with upper tract urothelial cancer, given that these patients were not included in this clinical trial and likely represent a biological subset distinct from primary bladder tumors. The subset of patients with upper tr...

I highly encourage enrollment in the EA8192 phase 3 trial, see details in the link below:

https://ecog-acrin.org/clinical-trials/ea8192-upper-urinary-tract-cancer/

Patients are randomized to neoadjuvant aMVAC with vs without Durvalumab.

In the absence of clinical trials, we are considering neoadjuvant ...