Greg (81 years old)

Greg, 81 years old, loves to prank his relatives. Last week, he replaced all family pictures in the house of his daughter with pictures of cats. She could not laugh about it as the family pictures accidentally ended up in the dustbin underneath the leftover spaghetti sauce.

He was diagnosed with UCa of the bladder with liver metastases. He was platinum-ineligible due to reduced GFR and a poor performance status. His tumour was strongly positive for PD-L1, so he started treatment with pembrolizumab. Now, 18 months later, he has a follow-up visit.

Assessment summary:

• Former smoker (40 pack years)
• Comorbidities: hypertension, chronic kidney disease, peripheral neuropathy grade 1
• ECOG PS: 2
• GFR: 45 ml/min
• CT scan: new liver lesions
• FGFR2/3 mutation status in diagnostic biopsy specimen: activating FGFR3 gene fusion