• ECOG 0\

‣ 2;

• HER-2 IHC 0-3+;

• Subjects underwent cystoscopic/ureteroscopic biopsy, exfoliation cytology, and CT/MRI diagnosis;

• Patients were judged to be high-risk urothelial carcinoma of the upper urinary tract (meeting any of the following risk factors: hydronephrosis, tumor diameter ≥2cm, high-grade, multiple tumors in cytology, previous history of radical cystectomy for high-grade bladder cancer, biopsy pathology with other tissue components);

• High-risk UTUC(excluding low-risk UTUC),including renal pelvic tumors (cT1-T3, N0) or ureteral tumors (cT1-T3, N0-N1) M0;

• Patients with indications of absolute or relative renal protection (only kidney, renal insufficiency: eGFR \< 60 ml/min)

• Have the desire to protect the kidney;

• There is no indication of absolute or relative kidney preservation, but patients have a strong desire to preserve kidney.

• Has and agrees to provide cystoscopic/ureteroscopic biopsy tissue specimens and to reserve pre-treatment blood,

⁃ Urine and biopsied biological samples;

⁃ Predicted survival ≥3 months;

⁃ Major organ function is normal (14 days prior to enrollment)

⁃ International Normalized ratio (INR), activated partial thromboplastin time (aPTT) : ≤1.5× ULN (This criterion only applies to patients who are not receiving anticoagulant therapy; Patients receiving anticoagulant therapy should keep anticoagulants within therapeutic limits);

⁃ Did not receive systemic corticosteroid medication within 4 weeks prior to treatment;

⁃ Fertile men or women who are at risk of becoming pregnant must use a highly effective contraceptive method during the trial (such as oral contraceptives, intrauterine devices, controlled sexual desire or barrier contraception combined with spermicide) and continue using contraception for 12 months after the end of treatment;

⁃ The subjects voluntarily joined the study, signed the informed consent, had good compliance, and cooperated with follow-up.