Bladder cancer
INACTIVE --- It’s getting personalised: first-line therapy of synchronous or metachronous mUCa

Jonas (59 years old)

Jonas is a 65-year-old gardener who likes to grow his own vegetables. His pumpkins are growing very fast this year. Maybe he will finally be able to beat his neighbour to have the biggest pumpkin in the street on Halloween.

He was diagnosed with high-grade MIBC T2N0M0 and underwent radical cystectomy combined with adjuvant gemcitabine + cisplatin. 5 months after completing adjuvant chemotherapy, a CT scan revealed liver metastases.

Assessment summary:

  • ECOG PS: 0
  • Peripheral neuropathy: grade I due to prior cisplatin
  • GFR: 42 ml/min
  • CT scan reveals diffuse liver metastases
  • Biopsy compatible with UCa
  • PD-L1 expression: low
  • Activating FGFR3 gene fusion in diagnostic biopsy specimen

Which treatment option would you choose for this patient?