Case 1: Lorenzo (73 years old)

Lorenzo, 73 years old, is a retired florist. You can still see how much he loves flowers as his house is full of vases filled with flowers in all colours of the rainbow.

He was diagnosed with locally advanced bladder cancer with bone and liver metastases. He received first-line treatment with cisplatin + gemcitabine. The first follow-up scan after the 3^rd cycle showed progressive disease with brain metastasis that was treated with stereotactic radiosurgery. He requires a daily dose of prednisone 50 mg.

Assessment summary:

• Medical history: hypertension
• CT scan of chest, abdomen and pelvis: new and enlarging bone and liver metastases
• ECOG PS: 0
• Glomerular filtration rate (GFR): 75 ml/min
• PD-L1 expression: low
• FGFR2/3 mutation status in diagnostic biopsy specimen: wild type