Bladder cancer
UPDATED --- First-line therapy of synchronous and metachronous metastatic UCa

Marc (73 years old)

Marc is a 73-year-old business analyst. 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, diabetes mellitus or autoimmune condition
  • Audiometric hearing loss: grade 1
  • GFR: 90 ml/min
  • Cardiac ejection fraction: 60%
  • PD-L1 expression: positive
  • FGFR2/3 alteration status in metastatic biopsy specimen: wild type

Which of the following options would you choose for this patient?