For patients with UTUC in whom nephroureterectomy would result in dialysis dependence, and in whom the disease is difficult to manage endoscopically, there is no currently available means to effectively deliver adjuvant chemotherapy to the upper tracts. These patients are thus either condemned to treatment with complete resection of their kidney and resultant hemodialysis, or risk progression of disease to an incurable and unmanageable state. MitoGel represents a promising treatment option for patients who have no other therapeutic options. For these reasons, MitoGel has been granted Orphan Designation Status by the FDA. While clinical trials of MitoGel are currently being planned, no trials are open to date.