New Section: Gemcitabine

Urologic Indications of Gemcitabine:

• In metastatic bladder cancer (urothelial carcinoma) (Si apre in una nuova finestra), gemcitabine is combined with cisplatin. For patients ineligible for cisplatin, substitution with carboplatin is used with somewhat lower efficacy.

• Neoadjuvant or adjuvant chemotherapy of bladder cancer (Si apre in una nuova finestra) or upper tract urothelial carcinoma in combination with cisplatin before or after curative surgery (cystectomy (Si apre in una nuova finestra) or nephroureterectomy (Si apre in una nuova finestra)).

• Off-label use in Europe: intravesical therapy of non-muscle invasive high-grade bladder cancer (Si apre in una nuova finestra) after BCG failure, sometimes in combination with docetaxel (Si apre in una nuova finestra). In the United States, since 2025, an intravesical gemcitabine delivery system (Inlexzo) has marketing authorization, which releases the drug over three weeks (Daneshmand et al., 2025).