New Section: Gemcitabine

Urologic Indications of Gemcitabine:

• In metastatic bladder cancer (urothelial carcinoma) (Abre numa nova janela), 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 (Abre numa nova janela) or upper tract urothelial carcinoma in combination with cisplatin before or after curative surgery (cystectomy (Abre numa nova janela) or nephroureterectomy (Abre numa nova janela)).

• Off-label use in Europe: intravesical therapy of non-muscle invasive high-grade bladder cancer (Abre numa nova janela) after BCG failure, sometimes in combination with docetaxel (Abre numa nova janela). 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).