Extra case 1: Rodrigo (67 years old)

Rodrigo is a 67-year-old, retired video game programmer. He was diagnosed with MIBC (cT3bN0M0) and received 4 cycles of neoadjuvant gemcitabine + cisplatin (GC) + durvalumab followed by RC + PLND without significant complications. Pathological review of the RC specimen indicated ypT2N0 (0/10) R0. He received adjuvant durvalumab for 8 cycles. 

First follow-up scans showed no evidence of disease, however, 9 months after completion of durvalumab, he presents with retroperitoneal lymph nodes (up to 3 cm short axes) and multiple lung metastases on CT.

Current situation:
•    Medical history: hypertension, chronic kidney disease
•    ECOG PS: 1
•    GFR: 45 ml/min
•    Peripheral neuropathy: grade 1
•    Audiometric hearing loss: grade 2
•    Biopsy of lung metastasis:

• Pure UCa
• Activating FGFR3 mutation