Treatment of Tumors in the Urinary Collecting System of the Kidney or Ureter Using a Light Activated Drug (WST11)
Upper Tract Urothelial Carcinoma
About this trial
This is an interventional treatment trial for Upper Tract Urothelial Carcinoma focused on measuring WST-11, Phototherapy, 18-140
Eligibility Criteria
Inclusion Criteria:
Age 18 or older
- Confirmed tissue diagnosis of urothelial carcinoma involving the ureter and/or renal pelvis with pathology reviewed at MSKCC
- Residual or recurrent cancer following prior endoscopic treatment
- Ineligible, unwilling or refusing to undergo surgical management by resection of involved kidney or ureter.
- Karnofsky performance status ≥ 50%
- Patients with existing ureteral obstruction and/or existing ureteral stent will be permitted. Demonstration of the site and degree of obstruction must be documented by retrograde pyelography at the time of initial and follow up endoscopic procedures within 60 days.
- Patients should not have received any systemic therapy (including chemotherapy, biologic therapy or immunotherapy) ≤4 weeks prior to treatment
- Patients on prophylactic or full-dose anticoagulation are eligible, provided the treating physician believes it is safe to temporarily withhold anticoagulation (see Section 9.2)
Adequate organ function defined at baseline as:
- ANC ≥1,000/ µL
- Platelets ≥75,000/ µL
- Hb ≥9 g/dl
- INR ≤1.5 (except for patients who are on full-dose warfarin)
- Calculated creatinine clearance ≥40 ml/min (using Cockcroft-Gault method)
- Total serum bilirubin ≤1.5 mg/dL
- AST/ALT ≤5× upper limit of normal
- Able to provide written informed consent
Exclusion Criteria:
Pregnant or breast-feeding women. Women of childbearing potential (WOCBP) must undergo a negative pregnancy test (either serum or urine) prior to study entry. Both sexes must use contraception while on study. WOCBP include:
- Any woman who has experienced menarche and who has not undergone surgical sterilization (hysterectomy, bilateral tubal ligation or oophorectomy) or who is not post-menopausal (defined as amenorrheic ≥12 consecutive months)
- Women on hormone replacement therapy with documented serum follicle stimulating hormone level > 35 mIU/ml
- Women who are using oral, implanted or injectable contraceptive hormones or mechanical products such as intrauterine device or barrier methods to prevent pregnancy or are practicing abstinence or where the partner is sterile
- T4 tumors with involvement of the bowel or major blood vessels • Any other medical or psychiatric comorbidities, including decompensated heart failure, unstable angina or coronary artery disease or severe pulmonary disease that, in the opinion of the study investigator, would make the patient a poor candidate for the study
Sites / Locations
- Memorial Sloan Kettering Cancer Center
Arms of the Study
Arm 1
Experimental
phototherapy with WST11
Patients with urothelial cancer that includes involvement of the upper urinary tract and have failed prior endoscopic treatment, refuse standard treatment, or are ineligible for curative surgical resection of the kidney or ureter will be offered WST11 VTP treatment to be provided at the time of scheduled endoscopic procedure. At the time of endoscopy, patients will be treated with VTP therapy applied to the site of the tumor.