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Your BLADDR challenge

Your BLADDR case challenge

Guillaume, a 55-years-old master chef in a famous 3-star restaurant, never tastes the food he prepares "because it goes straight to his hips", yet secretly stops by a highway hamburger restaurant on his way home for a big hamburger with French fries and a milkshake.

He is diagnosed with metastatic bladder cancer during a work up for dysuria.

Assessment summary:

  • Medical history: diabetes mellitus and diabetic nephropathy, otherwise healthy
  • CT chest, abdomen, pelvis: diffuse liver and lung metastases
  • ECOG PS: 0
  • Peripheral neuropathy: grade I due to diabetes mellitus
  • No hearing impairment, COPD or heart failure
  • Glomerular filtration rate (GFR): 40 ml/min due to diabetic nephropathy
  • PD-L1 expression: strongly positive, based on Agilent assay with CPS 50

What would you do next?