Katia (72 years old)

Katia, 72 years old, loves knitting. Her passion is so unbridled that the scarf she is making for her niece is now 2 metres long.

She was diagnosed with UCa of bladder with lung metastases, for which she received 6 cycles of gemcitabine + cisplatin. At the end of chemotherapy, CT revealed new lung lesions; pembrolizumab was started. 9 months later, she shows again progressive disease.

Assessment summary:

• No relevant medical history
• ECOG PS: 2; increasing breathlessness and cough
• CT chest, abdomen and pelvis: enlarged lesions in lungs
• FGFR2/3 status in tumour tissue specimen: activating FGFR3 gene fusion

The patient started erdafitinib with partial response, but 2 months later, she develops blurred vision making her unable to drive. On ophthalmologic examination, a diagnosis of grade 2 central serous chorioretinopathy was made. She is being followed up by an ophthalmologist with regular examinations. 

Erdafitinib treatment was withheld from the onset of the eye disorder, and 3 weeks later, the ocular symptoms resolved completely. After discussing with the ophthalmologist in detail you are deciding the next step.