Lawrence (73 years old)

73-year-old Lawrence, once a downhill biking champion, now finds joy in customising his nephew’s bike.

He initially presented with UCa of the bladder with liver metastases and was treated with gemcitabine + cisplatin + nivolumab. After 6 cycles of chemotherapy, he had partial response, so nivolumab was continued as maintenance treatment. 8 months later, he has progressive disease.

Assessment summary:

• Medical history: hypertension
• ECOG PS: 1
• No peripheral neuropathy
• No hearing impairment
• GFR: 65 ml/min
• CT scan reveals worsening of liver and new lung metastases
• FGFR2/3 alteration status in metastatic biopsy specimen: wild type