Giovanni (74 years old)

Giovanni is a 74-year-old retired translator. His favourite language is Dutch because it is so difficult to learn.

He was diagnosed 10 months ago with UCa of the bladder metastatic to the pelvic lymph nodes and lungs 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.

The patient started pembrolizumab, but 6 months later he shows again progressive disease.

Assessment summary:

• Medical history: grade 2 neuropathy due to cisplatin-based chemotherapy
• ECOG PS: 1; increasing breathlessness and cough
• CT scan of chest, abdomen and pelvis: new and enlarged lesions in the lungs
• FGFR2/3 mutation status in diagnostic biopsy specimen: wild type