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The robotic-assisted radical cystectomy, lymph node removal, and ileal conduit construction were performed; however, thirty days post-procedure, new occurrences of bone metastases and periaortic lymph node metastases were detected. The patient was prescribed gemcitabine and cisplatin (GC), which after four treatment courses yielded a Partial Response (PR), thus prompting a change to Avelumab as the maintenance th