Denis (77 years old)

77-year-old Denis worked as a judge for his whole life. Now he spends his days writing a memoir of his most memorable cases.

He is diagnosed with metastatic UCa of bladder.

Assessment summary:

• Medical history: obesity
• 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
• PD-L1 expression: low

The patient completed 4 cycles of gemcitabine + carboplatin with stable disease and maintenance with avelumab was started. After 5 cycles, the patient had partial response (complete remission of the diffuse liver metastases, but 4 bone metastases remaining). At this time, he experienced watery diarrhoea, cramping, urgency, and abdominal pain. Stool evaluation ruled out an infection. A diagnosis of grade 2 colitis was made.