What are the NCCN recommended first-line chemotherapy regimens advanced or metastatic bladder disease?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

For patients with advanced or metastatic disease, first-line chemotherapy regimens are as follows:

  • Gemcitabine and cisplatin (category 1 recommendation)
  • DDMVAC with growth factor support (category 1 recommendation)

For patients who cannot receive cisplatin-based chemotherapy due to renal impairment or other comorbidities, the NCCN lists the following regimens as preferred:

  • Gemcitabine and carboplatin
  • Atezolizumab (only for patients whose tumors express PD-L1 or who are not eligible for any platinum-containing chemotherapy regardless of PD-L1 expression)
  • Pembrolizumab (only for patients whose tumors express PD-L1 or who are not eligible for any platinum-containing chemotherapy regardless of PD-L1 expression)

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