Edward (73 years old)

Edward, 73 years old, is a retired train conductor. Sometimes he feels nostalgic and goes to the station just to hear the train's whistle for departure.

He is diagnosed with metastatic bladder cancer during a workup for dysuria.

Assessment summary:

• Former smoker (30 pack years)
• Medical history: hypertension
• CT scan of chest, abdomen and pelvis: bone and lung metastases
• Biopsy compatible with UCa
• ECOG PS: 1
• No peripheral neuropathy
• Audiometric hearing loss grade 1
• GFR: 90 ml/min
• Cardiac ejection fraction: 70%
• PD-L1 expression: strongly positive

The patient completed 4 cycles with gemcitabine + cisplatin and has now stable disease.