Bladder cancer
UPDATED --- First-line therapy of synchronous and metachronous metastatic UCa

Jake (70 years old)

After decades as a history teacher, 70-year-old Jake now writes detailed letters to his grandchildren, combining family history with world events, turning each note into a mini-lesson from the past.

Unfortunately, he is diagnosed with metastatic UCa of the bladder.

Assessment summary:

  • No relevant medical history
  • CT scan of chest, abdomen and pelvis: retroperitoneal and intrathoracic lymph node metastases, biopsy compatible with UCa
  • ECOG PS: 1
  • No peripheral neuropathy
  • No hearing impairment
  • GFR: 90 ml/min
  • PD-L1 expression: low

The patient completed 6 cycles first-line treatment with nivolumab + gemcitabine + cisplatin and has a complete response.

Which of the following options would you choose for this patient?