New Section: Gemcitabine

Urologic Indications of Gemcitabine:

• In metastatic bladder cancer (urothelial carcinoma) (Öffnet in neuem Fenster), 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 (Öffnet in neuem Fenster) or upper tract urothelial carcinoma in combination with cisplatin before or after curative surgery (cystectomy (Öffnet in neuem Fenster) or nephroureterectomy (Öffnet in neuem Fenster)).

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