Bella (69 years old)

Unlike many of her friends, 69-year-old Bella likes winter more than summer. Not because of the snow, but because of the long dark hours. She uses them as an excuse to sleep more.

She was diagnosed 8 months ago with UCa of the bladder with lungs metastasis and was treated with gemcitabine + cisplatin. The first scan showed a reduced metastatic burden; however, at the end of chemotherapy, the CT scan revealed new and enlarging lung lesions, after which she started pembrolizumab. The first scan after 2 months of pembrolizumab suggested slight enlargement of lung lesions.

Four months after starting pembrolizumab, the patient presents herself again.

Assessment summary:

• Former smoker (35 pack years)
• Medical history: hypertension, paroxysmal atrial fibrillation
• ECOG PS: 1
• Increasing breathlessness and cough
• CT scan showed further tumour progression
• FGFR2/3 mutation status in diagnostic biopsy specimen: activating FGFR3 mutation