Bladder cancer
INACTIVE --- New hope for patients progressing after prior treatment for mUCaArnold (75 years old)
Arnold, 75 years old, is a retired conductor of an orchestra. He still uses his old baton when music is playing, signalling hand gestures towards his guinea pigs. Not that they understand …
He was diagnosed with high-grade urothelial MIBC T2N0M0 and underwent neoadjuvant gemcitabine + cisplatin followed by radical chemoradiotherapy. Three months later, a CT scan revealed multiple retroperitoneal and intrathoracic lymph node metastases. He started pembrolizumab 7 months ago. After 12 weeks, a CT scan showed marginal progression in the lymph node metastases, but he continued with the immunotherapy. He presents again today.
Assessment summary:
- ECOG PS: 2
- Haemoglobin: 12.5 g/dl
- Peripheral neuropathy: grade 1 due to prior cisplatin
- Grade 2 immunotherapy-related hypothyroidism, treated with hormone replacement therapy
- No hearing impairment
- GFR: 45 ml/min
- CT scan reveals new and enlarging lymph node lesions
- FGFR2/3 mutation status in diagnostic biopsy specimen: wild type