{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:54:35Z","timestamp":1790927675234,"version":"4.1.0"},"reference-count":0,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Urol Int"],"abstract":"<jats:p>Introduction: Urinary pH is a low-cost host-related marker, but its association with immune checkpoint inhibitor outcomes in advanced urothelial carcinoma is uncertain. Methods: We retrospectively reviewed 45 consecutive patients with advanced urothelial carcinoma who received pembrolizumab or avelumab and had urinary pH measured at treatment initiation. Baseline urinary pH was categorized as \u22656.5 or &lt;6.5. Outcomes were objective response rate, progression-free survival, and overall survival. Cox models were adjusted for Bellmunt risk score. Early urinary pH dynamics were examined when available. Results: Baseline urinary pH was \u22656.5 in 20 patients and &lt;6.5 in 25. Objective response rate was 40.0% versus 16.0%, respectively. Baseline urinary pH \u22656.5 was associated with longer progression-free survival after Bellmunt adjustment (hazard ratio, 0.39; 95% confidence interval, 0.17\u20130.86), whereas the association with overall survival was weaker. Among 32 patients with early urinary pH data, objective response rate was 41.7% in the High-High group, 28.6% in the Low-High group, and 0% in the Low-Low group. In a pembrolizumab-only sensitivity cohort, the direction of association with real-world progression-free survival was preserved but attenuated. Conclusion: Urinary pH showed an exploratory association with checkpoint inhibitor outcomes. Because urinary pH is influenced by renal function, infection, medication, hydration, and diet, it should be interpreted as a hypothesis-generating host-related signal rather than a direct surrogate of tumor acidity.<\/jats:p>","DOI":"10.1159\/uin\/aewag031","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T12:17:28Z","timestamp":1790425048000},"source":"Crossref","is-referenced-by-count":0,"title":["Urinary pH and Checkpoint Inhibitor Outcomes in Advanced Urothelial Carcinoma: An Exploratory Brief Report"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3581-5122","authenticated-orcid":false,"given":"Satoshi","family":"Yamamoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Kanasugi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Shirafuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Bamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanji","family":"Kanaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,9,29]]},"container-title":["Urologia Internationalis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/uin\/aewag031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:18:35Z","timestamp":1790925515000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/uin\/aewag031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1159\/uin\/aewag031","archive":["Portico"],"relation":{},"ISSN":["0042-1138","1423-0399"],"issn-type":[{"value":"0042-1138","type":"print"},{"value":"1423-0399","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]}}}