I also have "small cell focal feature" bladder cancer. Chomo Nov 2017 cisplatin/etoposid. chemo didn't work. Had urostomy on 12/12/2017. metasatazied to my lungs and liver. bioposy on liver feb 2018. started Keytruda in Feb. 2018. Had 14 cycles of Ketruda. in nov. 2018 taken of immune theraphy because of bowell problems. dec 2018 c scan shows no change in status , blood work good. 2019 on hold now c scan in Feb. uncologist visit the 30th of Jan. 2019. I am feeling good. Tired out late afternoons evenings. My attitude is good. Just sharing.