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

Duarte (79 years old)

Duarte, 79 years old, watches a different classic movie every night, turning his living room into a mini cinema. He is diagnosed with metastatic bladder cancer during a workup for haematuria.

Assessment summary:

  • Medical history: obese, controlled diabetes mellitus (DM) and diabetic nephropathy, venous leg ulcers
  • CT chest, abdomen, pelvis: pelvic lymph node metastases and diffuse liver metastases, liver biopsy compatible with UCa
  • ECOG PS: 2
  • Peripheral neuropathy: grade 2 due to DM
  • No hearing impairment
  • GFR: 25 ml/min due to diabetic nephropathy
  • Cardiac ejection fraction: 60%
  • PD-L1 expression: strongly positive

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