Bladder Cancer Treatment Guidelines

First-Line Treatment

• The National Comprehensive Cancer Network recommends gemcitabine/cisplatin as a preferred regimen for cisplatin-eligible patients with metastatic bladder cancer 1
• The National Comprehensive Cancer Network recommends gemcitabine/carboplatin for cisplatin-ineligible patients, with overall response rates of approximately 41.2% 3
• The NCCN guidelines recommend enfortumab vedotin + pembrolizumab as the preferred first-line regimen for both cisplatin-eligible and cisplatin-ineligible patients with advanced or metastatic urothelial cancer 5

Toxicity Profile

• Gemcitabine combinations can cause significant hematologic toxicities, including Grade 3/4 neutropenia in 50.5% of patients with gemcitabine/cisplatin 3
• Gemcitabine combinations can cause Grade 3/4 anemia, which is common in combination regimens 3

Treatment Regimens

• Gemcitabine/cisplatin is a recommended regimen for cisplatin-eligible patients with metastatic bladder cancer, according to the National Comprehensive Cancer Network 2
• Gemcitabine-based regimens are now categorized as "other recommended regimens" rather than preferred options, according to the National Comprehensive Cancer Network 5