(UroToday.com) Upper tract urothelial carcinoma (UTUC) is a relatively rare malignancy, comprising a small subset of urothelial disease. Compared to bladder cancer, endoscopic management of UTUC and intraluminal therapy is substantially more difficult. As a result, organ-preserving treatments are technically difficult. Thus, these approaches are often reserved for easily accessible, small, low-grade tumors. However, novel approaches are being evaluated to expand the population of patients who may receive nephron-sparing treatments. Vascular-targeted photodynamic therapy (VTP) using intravascular photosensitizing agent padeliporfin (WST11) has demonstrated preclinical efficacy in preclinical animal models and provides an alternative to extirpative surgery in patients unable or unwilling to undergo extirpative surgery.