Bladder cancer
UPDATED --- Targeted therapies for metastatic UCa in special populations

Orson (74 years old)

Orson, 74 years old, listens to old radio broadcasts from decades past, carefully archiving his favourites on cassette tapes.

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:

  • Medical history: grade 2 neuropathy due to cisplatin-based chemotherapy
  • 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

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