Neoadjuvant Upper Tract Invasive Cancer Trial (NAUTICAL)

To be considered for this study, you would generally need to have been recently diagnosed with this specific type of cancer in your kidney or ureter, and it should be visible on scans like CT or MRI. You also need to be 18 years or older and generally in good health, meaning you can carry out your normal daily activities without much difficulty. Importantly, your medical team will need to confirm that you are healthy enough to undergo both surgery and the specific chemotherapy medicines used in the study.

There are also some important reasons why you might not be able to join. For example, if your cancer has already spread to distant parts of your body or to your lymph nodes, or if you have another type of cancer diagnosis within the last two years (bladder cancer with specific treatments might be an exception). You also wouldn't be able to participate if you have serious hearing problems, significant nerve damage (neuropathy) from other conditions, or if you have a single kidney that's not functioning well.

If you join this study, you would first have an assessment to determine if you are suitable for chemotherapy before surgery. You would then be randomly assigned to either receive chemotherapy before your surgery or to go straight to surgery as is the current standard. If your cancer is found to be more advanced after surgery, you might also receive chemotherapy afterwards, depending on what group you were assigned to initially. You'll have regular hospital visits for scans, blood tests, and to see your doctors to check how you're responding to treatment and to monitor for any side effects. The total duration of your participation would depend on your treatment plan and follow-up schedule, which your doctor will explain in detail.