UroGen Announces 5-Year Long-Term Extension Study of the OPTIMA II Trial Demonstrates Long-Term Durability of Response to ZUSDURI in Patients With Low-Grade Intermediate-Risk Non-Muscle Invasive Bladder Cancer

UroGen Pharma Ltd. recently announced the publication of results of a5-year long-term extension study of the Phase 2b OPTIMA II trial evaluating ZUSDURI (mitomycin) for intravesical solution in patients with low-grade intermediate-risk non-muscle invasive bladder cancer (LG-IR-NMIBC) demonstrating durable, long-term complete responses (CRs) in patients who initially achieved a CR following treatment with ZUSDURI. The publication, titled Treatment of Low-Grade Intermediate-Risk Non-Muscle Invasive Bladder Cancer With UGN-102: Outcomes From the 5-year Long-Term Extension Study of the Single-Arm, Phase 2b OPTIMA II Study, is now available online at https://doi.org/10.1016/j.clgc.2025.102392.

“Low-grade intermediate-risk bladder cancer is a chronic, recurring disease that often requires repeated surgical intervention,” said Neal D. Shore, MD, FACS Medical Director for the START Carolinas/Carolina Urologic Research Center and lead author of the study. “The long-term data from the extension study of OPTIMA II highlight ZUSDURI’s ability to deliver sustained responses in an outpatient setting, which may be especially valuable for recurrent patients and thus for physicians who prefer a different, non-surgical treatment option.”

Among the 41 patients who achieved CR at 3 months post-treatment with ZUSDURI in the OPTIMA II trial, 25 remained in CR at 12 months and 17 entered the long-term follow-up study. For the 41 patients achieving CR at three months, the median Kaplan-Meier estimate of duration of response (DOR) was 24.2 months (95% CI 9.7, 42.1) with a median follow-up of 35.8 months. For the 17 patients in the long-term follow-up study, the median DOR was 42.1 months by Kaplan-Meier estimate (95% CI: 24.2, NE), with a median follow-up of 50.4 months. These results build upon previously published 12-month DOR data, showing ZUSDURI’s potential to deliver meaningful, lasting event-free periods.

“These results reflect our continued commitment to bringing forward innovative treatments that give patients and physicians more options,” said Mark Schoenberg, MD, Chief Medical Officer, UroGen. “For recurrent patients facing repeated surgeries, it offers a non-surgical approach that can empower patients and providers to choose a path that best fits individual needs and preferences.”

Safety data were not collected during the long-term follow-up trial. The most commonly reported treatment emergent adverse events (>10% of patients) from the parent OPTIMA II study were dysuria in 26 (41% of patients); pollakiuria in 13 (21%); hematuria in 10 (16%); urgency to urinate or urinary tract infection, both occurring in 9 (14%); and fatigue in 7 (11%).

The OPTIMA II trial included both newly diagnosed and recurrent adult patients with LG-IR-NMIBC. Of the 17 patients that entered long-term follow up, 16 (94%) were recurrent and 1 (6%) was newly diagnosed. This cohort of patients had a median DOR of 3.5 years by Kaplan-Meier estimate. ZUSDURI is indicated only for the treatment of adults with recurrent LG-IR-NMIBC.

ZUSDURI (mitomycin) for intravesical solution is an innovative drug formulation of mitomycin, approved for the treatment of adults with recurrent LG-IR-NMIBC. Utilizing UroGen’s proprietary RTGel technology, a sustained release, hydrogel-based formulation, ZUSDURI is delivered directly into the bladder in an out-patient procedure by a trained healthcare professional using a urinary catheter to enable the treatment of tumors by non-surgical means. Visit ZUSDURI.com for more information.

LG-IR-NMIBC affects around 82,000 people in the US every year and of those, an estimated 59,000 are recurrent. Bladder cancer primarily affects older populations with increased risk of comorbidities, with the median age of diagnosis being 73 years. Guideline recommendations for the management of NMIBC include trans-urethral resection of bladder tumor (TURBT) as the standard of care. Up to 70% of NMIBC patients experience at least one recurrence, and LG-IR-NMIBC patients are even more likely to recur and face repeated TURBT procedures. Learn more about non-muscle invasive bladder cancer at www.BladderCancerAnswers.com.

OPTIMA II (OPTimized Instillation of Mitomycin for Bladder Cancer Treatment) was an open-label, single-arm, multi-center Phase 2b clinical trial of ZUSDURI to evaluate its safety and efficacy in patients with LG-IR-NMIBC. Learn more about the Phase 2b OPTIMA II trial at www.clintrials.gov (NCT03558503).

UroGen is a biotech company dedicated to developing and commercializing innovative solutions that treat urothelial and specialty cancers because patients deserve better options. UroGen has developed RTGel reverse-thermal hydrogel, a proprietary sustained-release, hydrogel-based platform technology that has the potential to improve the therapeutic profiles of existing drugs. UroGen’s sustained release technology is designed to enable longer exposure of the urinary tract tissue to medications, making local therapy a potentially more effective treatment option. Our first product to treat low-grade upper tract urothelial cancer and ZUSDURI (mitomycin) for intravesical solution, our first product to treat recurrent LG-IR-NMIBC are both designed to ablate tumors by non-surgical means. UroGen is headquartered in Princeton, NJ with operations in Israel. Visit www.UroGen.com.