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An initial attempt to obtain an insurance approval for pembrolizumab given LS and context of deficient mismatch repair was unsuccessful. She subsequently received neoadjuvant gemcitabine and split-dose cisplatin, leading to a complete pathological response, ypT0N0.<\/jats:p>","DOI":"10.1136\/bcr-2025-265380","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T06:15:20Z","timestamp":1759299320000},"page":"e265380","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Peri-operative management considerations for localised upper tract urothelial carcinoma in the setting of Lynch syndrome"],"prefix":"10.1136","volume":"18","author":[{"given":"Lucia","family":"Notardonato","sequence":"first","affiliation":[{"name":"Hematology Oncology, University of Illinois Chicago, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3597-1838","authenticated-orcid":false,"given":"Ahsan","family":"Wahab","sequence":"additional","affiliation":[{"name":"Hematology Oncology, University of Illinois Chicago, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Reizine","sequence":"additional","affiliation":[{"name":"Hematology Oncology, University of Illinois Chicago, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karine","family":"Tawagi","sequence":"additional","affiliation":[{"name":"Hematology Oncology, University of Illinois Chicago, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"2025093023151120000_18.9.e265380.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3878"},{"key":"2025093023151120000_18.9.e265380.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2008.08.008"},{"key":"2025093023151120000_18.9.e265380.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-016-1928-x"},{"key":"2025093023151120000_18.9.e265380.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.05.042"},{"key":"2025093023151120000_18.9.e265380.5","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1200\/JCO.23.02679","article-title":"Understanding Adjuvant Therapy for Upper Tract Urothelial Carcinoma","volume":"42","author":"Berg","year":"2024","journal-title":"J Clin Oncol"},{"key":"2025093023151120000_18.9.e265380.6","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/S0140-6736(20)30415-3","article-title":"Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial","volume":"395","author":"Birtle","year":"2020","journal-title":"The Lancet"},{"key":"2025093023151120000_18.9.e265380.7","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1200\/JCO.22.00763","article-title":"Multicenter Phase II Clinical Trial of Gemcitabine and Cisplatin as Neoadjuvant Chemotherapy for Patients With High-Grade Upper Tract Urothelial Carcinoma","volume":"41","author":"Coleman","year":"2023","journal-title":"J Clin Oncol"},{"key":"2025093023151120000_18.9.e265380.8","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1200\/JCO.24.00340","article-title":"Adjuvant Nivolumab in High-Risk Muscle-Invasive Urothelial Carcinoma: Expanded Efficacy From CheckMate 274","volume":"43","author":"Galsky","year":"2025","journal-title":"J Clin Oncol"},{"key":"2025093023151120000_18.9.e265380.9","unstructured":"Avanza T . 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