{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:02:55Z","timestamp":1790596975710,"version":"4.1.0"},"reference-count":11,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry for Innovation and Technology","award":["K139059"],"award-info":[{"award-number":["K139059"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Urachal cancer (UrC) is a rare disease which is mostly diagnosed late due to symptoms caused by its local invasion to the urinary bladder. Given the lack of clinical trials and guideline recommendations for systemic treatment, a molecularly informed precision oncology approach is a viable option for UrC already in the early lines of systemic treatment. While single case experiences may provide valuable reference for later decision-making, well-documented clinical experience with off-label targeted treatments is limited to a few patients. Here, we report a case of a 31-year-old female UrC patient who underwent intensive therapy with three surgeries and five lines of systemic treatments, including chemo-, checkpoint inhibitor and tyrosine kinase inhibitor therapies. In addition, next-generation sequencing (NGS) analysis and an ex vivo drug-screening analysis were performed on patient-derived tumor cells and the results were implemented into the therapeutic decision-making. Finally, serum carcinoembryonic antigen (CEA) levels proved to be helpful for therapy monitoring during the whole follow-up period.<\/jats:p>","DOI":"10.3390\/ijms252413315","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T03:52:49Z","timestamp":1733975569000},"page":"13315","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Precision Oncology Approach for Urachal Carcinoma: A Clinical Case Report"],"prefix":"10.3390","volume":"25","author":[{"given":"D\u00e1niel","family":"Juh\u00e1sz","sequence":"first","affiliation":[{"name":"Department of Urology, Semmelweis University, \u00dcll\u0151i Street 78\/b, H-1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Csizmarik","sequence":"additional","affiliation":[{"name":"Department of Urology, Semmelweis University, \u00dcll\u0151i Street 78\/b, H-1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e1nos","family":"Szalontai","sequence":"additional","affiliation":[{"name":"Department of Urology, Semmelweis University, \u00dcll\u0151i Street 78\/b, H-1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"Keszthelyi","sequence":"additional","affiliation":[{"name":"Department of Urology, Semmelweis University, \u00dcll\u0151i Street 78\/b, H-1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1lint","family":"D\u00e9r","sequence":"additional","affiliation":[{"name":"Department of Urology, Semmelweis University, \u00dcll\u0151i Street 78\/b, H-1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6901-9701","authenticated-orcid":false,"given":"Andr\u00e1s","family":"Kubik","sequence":"additional","affiliation":[{"name":"Department of Urology, Semmelweis University, \u00dcll\u0151i Street 78\/b, H-1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikl\u00f3s","family":"Sz\u0171cs","sequence":"additional","affiliation":[{"name":"Department of Urology, Semmelweis University, \u00dcll\u0151i Street 78\/b, H-1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6963-8489","authenticated-orcid":false,"given":"Istv\u00e1n","family":"Kenessey","sequence":"additional","affiliation":[{"name":"Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, H-1082 Budapest, Hungary"},{"name":"National Cancer Registry and Centre for Biostatistics, National Institute of Oncology, H-1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7564-9694","authenticated-orcid":false,"given":"Iris E.","family":"Ertl","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Vienna, Comprehensive Cancer Center, A-1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0014-1658","authenticated-orcid":false,"given":"Walter","family":"Berger","sequence":"additional","affiliation":[{"name":"Center for Cancer Research, Medical University of Vienna, Comprehensive Cancer Center, A-1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Englinger","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Vienna, Comprehensive Cancer Center, A-1090 Vienna, Austria"},{"name":"Center for Cancer Research, Medical University of Vienna, Comprehensive Cancer Center, A-1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6627-6179","authenticated-orcid":false,"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Vienna, Comprehensive Cancer Center, A-1090 Vienna, Austria"},{"name":"Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA"},{"name":"Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA"},{"name":"Department of Urology, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic"},{"name":"Karl Landsteiner Institute of Urology and Andrology, A-1010 Vienna, Austria"},{"name":"Research Center for Evidence Medicine, Urology Department Tabriz University of Medical Sciences, Tabriz 5166\/15731, Iran"},{"name":"Division of Urology, Department of Special Surgery, Jordan University Hospital, University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Nyir\u00e1dy","sequence":"additional","affiliation":[{"name":"Department of Urology, Semmelweis University, \u00dcll\u0151i Street 78\/b, H-1082 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tibor","family":"Szarvas","sequence":"additional","affiliation":[{"name":"Department of Urology, Semmelweis University, \u00dcll\u0151i Street 78\/b, H-1082 Budapest, Hungary"},{"name":"Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK), Hufelandstr. 55, D-45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"221.e1","DOI":"10.1016\/j.urolonc.2024.03.011","article-title":"Estimation of the incidence of urachal cancer: A systematic review and meta-analysis of registry-based studies","volume":"42","author":"Olah","year":"2024","journal-title":"Urol. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/j.juro.2012.06.020","article-title":"The clinical epidemiology of urachal carcinoma: Results of a large, population based study","volume":"188","author":"Bruins","year":"2012","journal-title":"J. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1159\/000509481","article-title":"Urachal Cancer in Germany and the USA: An RKI\/SEER Population-Based Comparison Study","volume":"104","author":"Hager","year":"2020","journal-title":"Urol. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1111\/iju.14154","article-title":"Clinicopathological features of malignant urachal tumor: A hospital-based cancer registry data in Japan","volume":"27","author":"Nagumo","year":"2020","journal-title":"Int. J. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.urolonc.2016.04.012","article-title":"Clinical, prognostic, and therapeutic aspects of urachal carcinoma-A comprehensive review with meta-analysis of 1010 cases","volume":"34","author":"Szarvas","year":"2016","journal-title":"Urol. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1002\/cncr.33328","article-title":"Results of a multicenter, phase 2 study of nivolumab and ipilimumab for patients with advanced rare genitourinary malignancies","volume":"127","author":"McGregor","year":"2021","journal-title":"Cancer"},{"key":"ref_7","unstructured":"Langdon, S.P. (2004). Formulations of Commonly Used Cell Culture Media. Cancer Cell Culture: Methods and Protocols, Humana Press."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"M\u00e4kel\u00e4, R., Arjonen, A., H\u00e4rm\u00e4, V., Rintanen, N., Paasonen, L., Paprotka, T., R\u00f6nsch, K., Kuopio, T., Kononen, J., and Rantala, J.K. (2020). Ex vivo modelling of drug efficacy in a rare metastatic urachal carcinoma. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-07092-w"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1097\/01.ju.0000054646.49381.01","article-title":"Multimodality management of urachal carcinoma: The M. D. Anderson Cancer Center experience","volume":"169","author":"Gee","year":"2003","journal-title":"J. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"9041","DOI":"10.1002\/cam4.5639","article-title":"Clinical sequencing identifies potential actionable alterations in a high rate of urachal and primary bladder adenocarcinomas","volume":"12","author":"Varadi","year":"2023","journal-title":"Cancer Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1002\/ijc.31547","article-title":"Pathogenic and targetable genetic alterations in 70 urachal adenocarcinomas","volume":"143","author":"Reis","year":"2018","journal-title":"Int. J. Cancer"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/24\/13315\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:53:02Z","timestamp":1760115182000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/24\/13315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,12]]},"references-count":11,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["ijms252413315"],"URL":"https:\/\/doi.org\/10.3390\/ijms252413315","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,12]]}}}