Case 2023: Elena (expert opinion by B. Szabados)

Elena, 75 years old, secretly enjoys challenging tourists in ordering the correct coffee: Un nublado, un cortado, or un sombra, …? She loves educating her foreign customers on all the differences. Probably, a remaining passion from her previous career as high school teacher.

She is diagnosed with metastatic bladder cancer during a workup for haematuria.

Assessment summary:

• Former smoker (30 pack years)
• Medical history: hypertension
• CT scan of chest, abdomen and pelvis: bone and lung metastases
• Biopsy compatible with urothelial cancer
• ECOG PS: 1
• No peripheral neuropathy
• No hearing loss
• GFR: 90 ml/min
• Cardiac ejection fraction: 65%
• PD-L1 expression: CPS 25

The patient completed 4 cycles with gemcitabine + cisplatin and now has stable disease (SD). She developed grade 1 neuropathy and fatigue.