{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:47:03Z","timestamp":1791474423208,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Combining the probiotic product CBM588 with immune checkpoint inhibitors (ICIs) has shown improved prognosis in several cancers. Pembrolizumab alone as a second\u2010line treatment for urothelial cancer (UC) extends prognosis by only 3\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This is a retrospective study that examined the\u00a0effects of CBM588 combined with pembrolizumab in advanced UC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>The study included 44 patients who had recurrence or progression after first\u2010line chemotherapy with cisplatin or carboplatin. The study compared 33 patients treated with pembrolizumab alone and 11 patients treated with CBM588 plus pembrolizumab over a median observation period of 12\u2009months. The combination of CBM588 and pembrolizumab significantly improved progression\u2010free survival (PFS; <jats:italic>p<\/jats:italic> = 0.004) and overall survival (OS; <jats:italic>p<\/jats:italic> = 0.02). Multivariate analysis identified CBM588 as a significant prognostic factor for both PFS (hazard ratio: 0.074, <jats:italic>p<\/jats:italic> = 0.0008) and OS (hazard ratio: 0.105, <jats:italic>p<\/jats:italic> = 0.0056).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results suggest the effectiveness of the CBM588 combination with ICI treatment in UC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.70308","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T06:49:26Z","timestamp":1754462966000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic Impact of <scp><i>Clostridium butyricum<\/i> MIYAIRI<\/scp> (<scp>CBM588<\/scp>) in Combination With Pembrolizumab for Advanced Urothelial Carcinoma: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1623-7371","authenticated-orcid":false,"given":"Junya","family":"Arima","sequence":"first","affiliation":[{"name":"Department of Urology, Graduate School of Medical and Dental Sciences Kagoshima University  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5470-7445","authenticated-orcid":false,"given":"Hirofumi","family":"Yoshino","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medical and Dental Sciences Kagoshima University  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Tatarano","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medical and Dental Sciences Kagoshima University  Kagoshima 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