{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:47Z","timestamp":1787014367071,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"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":["Int J of Urology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Second\u2010line pembrolizumab improves the overall survival (OS) of patients with metastatic urothelial carcinoma (UC). We sought to develop and validate a risk model that can predict OS and response duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed patients with advanced UC treated with second\u2010line pembrolizumab at a single institution. Factors predicting time to progression (TTP) were assessed in univariate and multivariate Cox regression. Patients were divided into risk groups according to independent TTP predictors. The impact of risk group on OS was assessed. Validation utilized an independent dataset from 59 centers. Survival was estimated using the Kaplan\u2013Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study comprised 565 patients (creation: 69; validation: 496). Factors predicting inferior TTP in multivariate analysis: interval from prior chemotherapy &lt;\u20096\u2009months (HR: 2.06, 95% CI: 1.16\u20133.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014), liver metastasis (HR: 2.39, 95% CI: 1.29\u20134.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), and Eastern Cooperative Oncology Group Performance Status &gt;\u20091 (HR: 4.62, 95% CI: 2.42\u20138.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Median OS in the creation cohort was 29, 8.3, and 3.7\u2009months for favorable (0 risk factors), intermediate (1 risk factor), and poor\u2010risk (\u2265\u20092 risk factors) groups, respectively, with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001. The corresponding OS times in the validation cohort were 21.6, 11.7, and 4.9\u2009months, respectively, with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001. Among responders, median duration of response was 38.9, 13.8, and 7.8\u2009months for the favorable, intermediate, and poor\u2010risk groups, respectively, with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We developed and validated a risk model that can predict response durability and OS after second\u2010line pembrolizumab for advanced UC. Alternative treatments might be warranted for the poor\u2010risk group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70178","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T13:05:31Z","timestamp":1752843931000},"page":"1569-1575","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessing Response Durability and Survival After Second\u2010Line Pembrolizumab in Advanced Urothelial Carcinoma: A Multicenter Validation of a Risk Model"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7421-2522","authenticated-orcid":false,"given":"Samer","family":"Salah","sequence":"first","affiliation":[{"name":"Medical Oncology Department King Fahad Specialist Hospital  Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6322-9190","authenticated-orcid":false,"given":"Katsuhiro","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Urology Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6942-9695","authenticated-orcid":false,"given":"Yuki","family":"Kita","sequence":"additional","affiliation":[{"name":"Department of Urology Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1069-2816","authenticated-orcid":false,"given":"Takashi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulraheem","family":"Alshangiti","sequence":"additional","affiliation":[{"name":"Medical Oncology Department King Fahad Specialist Hospital  Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Azam","sequence":"additional","affiliation":[{"name":"Medical Oncology Department King Fahad Specialist Hospital  Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Abdeljalil","sequence":"additional","affiliation":[{"name":"Medical Oncology Department King Fahad Specialist Hospital  Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Ibnshamsah","sequence":"additional","affiliation":[{"name":"Medical Oncology Department King Fahad Specialist Hospital  Dammam Saudi 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D.Galsky \u201cCharacterization of Complete Responders to Nivolumab + Gemcitabine\u2010Cisplatin Versus Gemcitabine\u2010Cisplatin Alone in Patients with lymph Node\u2013Only Metastatic Urothelial Carcinoma from the CheckMate 901 Trial. [conference presentation abstract] \u201d42(2024):4509 ASCO Annual Meeting Chicago Il USA https:\/\/doi.org\/10.1200\/JCO.2024.42.16_suppl.450.","DOI":"10.1200\/JCO.2024.42.16_suppl.4509"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035807"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2308849"}],"container-title":["International Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iju.70178","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iju.70178","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iju.70178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T11:16:21Z","timestamp":1773746181000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iju.70178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,18]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/iju.70178"],"URL":"https:\/\/doi.org\/10.1111\/iju.70178","archive":["Portico"],"relation":{},"ISSN":["0919-8172","1442-2042"],"issn-type":[{"value":"0919-8172","type":"print"},{"value":"1442-2042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,18]]},"assertion":[{"value":"2025-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}