Bladder cancer
Handling AEs of targeted therapies for metastatic UCa

Pablo (68 years old)

Pablo is a 68-year-old famous singer. He is a legendary musician in his home country and has performed in countless concerts worldwide.

He was diagnosed with UCa of bladder metastatic to pelvic lymph nodes and lungs and was treated with first-line gemcitabine + cisplatin. At the end of chemotherapy, CT revealed new and enlarging lung lesions. Treatment with pembrolizumab was started, but 6 months later he shows again progressive disease.

Assessment summary:

  • No relevant medical history
  • ECOG PS: 1; increasing breathlessness and cough
  • CT chest, abdomen and pelvis: new and enlarged lesions in lungs
  • FGFR2/3 status in tumour tissue specimen: wild type

The patient started enfortumab vedotin (EV) with partial response; 5 months after starting EV, the patient develops grade 2 peripheral neuropathy. 

Pharmacological intervention is being started to manage the neuropathic pain.

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