{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T22:56:54Z","timestamp":1790549814590,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Urachal carcinoma is a rare and aggressive malignancy with no established systemic therapy after platinum failure. Evidence for immune checkpoint inhibitors (ICIs) remains limited, particularly in tumors without established favorable biomarkers such as microsatellite instability\u2010high status or high tumor mutational burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 55\u2010year\u2010old woman with metastatic urachal adenocarcinoma progressed after seven cycles of gemcitabine\u2013cisplatin. Pembrolizumab (200\u2009mg every three weeks) was initiated, resulting in a durable partial response lasting over 12\u2009months without immune\u2010related adverse events. Molecular profiling showed microsatellite stability, low tumor mutational burden, and insufficient tissue for (Programmed death\u2010ligand 1) PD\u2010L1 assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case demonstrates durable disease control with pembrolizumab in metastatic urachal carcinoma despite microsatellite stability and low tumor mutational burden. These findings suggest the potential efficacy of pembrolizumab in selected patients with platinum\u2010refractory disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iju5.70276","type":"journal-article","created":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T22:39:25Z","timestamp":1790548765000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metastatic Urachal Carcinoma With Microsatellite Stability and Low Tumor Mutational Burden Achieving a Durable Response to Pembrolizumab After Platinum Failure"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7240-6113","authenticated-orcid":false,"given":"Fumihiro","family":"Ito","sequence":"first","affiliation":[{"name":"Department of Urology Gifu Prefectural Tajimi Hospital  Tajimi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology Gifu Prefectural Tajimi Hospital  Tajimi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0978-3230","authenticated-orcid":false,"given":"Gaku","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Urology Gifu Prefectural Tajimi Hospital  Tajimi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4832-7510","authenticated-orcid":false,"given":"Shunsuke","family":"Kamijo","sequence":"additional","affiliation":[{"name":"Department of Urology Gifu Prefectural Tajimi Hospital  Tajimi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0214-7265","authenticated-orcid":false,"given":"Takashi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Urology Gifu Prefectural Tajimi Hospital  Tajimi 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