Tristan (75 years old)

Tristan, 75 years old and often distracted, plays the trumpet. When he plays in the brass band, he often suddenly stops because he sees a bird flying over or a car passing by. A major challenge for the conductor.

He was diagnosed with high-grade urothelial muscle-invasive bladder cancer (MIBC) T2N0M0 and underwent neoadjuvant gemcitabine + cisplatin followed by radical chemoradiotherapy. Three months after radical chemoradiotherapy, a CT scan revealed multiple retroperitoneal and intrathoracic lymph node metastases. He started pembrolizumab 7 months ago and presents himself again today.

Assessment summary:

• ECOG PS: 1
• Haemoglobin: 12.5 g/dl
• Peripheral neuropathy: grade 1 due to prior cisplatin
• No hearing impairment
• GFR: 45 ml/min
• CT scan reveals new and enlarging lymph node lesions
• FGFR2/3 mutation status in diagnostic biopsy specimen: wild type