Bladder cancer
New hope for patients progressing after prior treatment for mUCa

Massimo (81 years old)

Massimo, 81 years old, loves pranking his family. Last month, he made their smart home assistant talk like a pirate. His grandson laughed, but his daughter wasn't happy searching for the light switch in the dark.

Unfortunately, he was diagnosed with UCa of the bladder with liver metastases. He was platinum ineligible, but his tumour was strongly positive for PD-L1, so he started treatment with pembrolizumab. Now, 18 months later, he has a follow-up visit.

Assessment summary:

  • Former smoker (40 pack years)
  • Comorbidities: hypertension and chronic kidney disease
  • Peripheral neuropathy: grade 1
  • ECOG PS: 2
  • GFR: 30 ml/min
  • Haemoglobin: 8.6 g/dl
  • CT scan reveals new liver lesions
  • FGFR2/3 alteration status in metastatic biopsy specimen: activating FGFR3 gene fusion

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