Fabian (74 years old)

Fabian, 74 years old, spends his mornings birdwatching from his garden, noting every new visitor in a journal he has kept for years.

He was diagnosed 10 months ago with UCa of the bladder metastatic to the pelvic lymph nodes and lungs and was treated with gemcitabine + cisplatin. The first scan showed a reduced metastatic burden; however, at the end of chemotherapy, the CT scan revealed new and enlarging lung lesions.

The patient started pembrolizumab, but 6 months later he shows again progressive disease.

Assessment summary:

• No relevant medical history
• ECOG PS: 1; increasing breathlessness and cough
• CT scan of chest, abdomen and pelvis: new and enlarged lesions in the lungs
• FGFR2/3 mutation status in diagnostic biopsy specimen: wild type