Multimodal Kidney-Sparing Strategy for High-Risk Upper Tract Urothelial Carcinoma

UTUC is a cancer that develops in the lining of the kidney or ureter. The standard treatment is radical nephroureterectomy, which removes the kidney and ureter. Although this surgery can control the cancer, it permanently reduces kidney function. Endoscopic treatment can serve as a kidney-sparing approach for low-risk UTUC; however, in high-risk patients, the high rate of upper tract local recurrence after endoscopic treatment remains the primary failure pattern. This study aims to evaluate the efficacy and safety of radiotherapy-involved kidney-sparing treatment for UTUC. The main questions this study aims to answer are: Can this multimodal kidney-sparing strategy reduce local recurrence of UTUC compared with endoscopic treatment alone? Participants in the kidney-sparing group will: Undergo endoscopic surgery to remove the tumor; Receive systemic therapy with disitamab vedotin and toripalimab; Receive targeted radiotherapy after surgery. Participants will undergo regular follow-up visits, including imaging examinations and endoscopic evaluations, to monitor for recurrence or disease progression. The results of this study may help determine whether a multimodal kidney-sparing treatment strategy could become a safe and effective option for selected patients with high-risk UTUC.

NCT Number	NCT07504939
Lead Sponsor	Peking University First Hospital
Conditions	Upper Tract Urothelial Carcinoma Receiving Kidney-sparing Therapy, Upper Tract Urothelial Carcinoma
Enrollment	36 participants
Start Date	2026-04-01
Primary Completion	2030-04-01 (estimated)
Study Completion	2030-04-01 (estimated)
Updated on ClinicalTrials.gov	2026-04-24