Jean-Luc (78 years old)

Jean-Luc, 78 years old and a retired microbiologist, regularly invites his granddaughters to inspect tap water under the microscope, sharing his passion for the unseen world and sparking their curiosity about science.

He is diagnosed with metastatic UCa of bladder.

Assessment summary:

• Medical history:
  • Type 2 diabetes mellitus, previously poorly controlled (HbA1c 9.5%), currently improved under endocrinology follow-up
  • Hypertension
• CT scan of chest, abdomen and pelvis: diffuse liver and bone metastases, biopsy compatible with UCa
• ECOG PS: 1
• No peripheral neuropathy
• No hearing impairment
• GFR: 40 ml/min

The patient completed 4 cycles of gemcitabine + carboplatin and achieved stable disease.  Maintenance with avelumab was initiated. After 5 cycles of avelumab, imaging demonstrated a partial response, with marked regression of liver metastases and 4 residual bone lesions remaining.

At this time, he developed watery diarrhoea, abdominal cramping, urgency, and abdominal pain. Stool evaluation excluded an infectious cause. A diagnosis of grade 3 immune-mediated colitis was made, and the patient was hospitalised for in-patient care.