What are the NCCN second-line therapy recommendations for the treatment of bladder cancer?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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For subsequent systemic therapy for locally advanced or metastatic disease stage IV, the NCCN recommends participation in clinical trials of new agents. Preferred agents are as follows:

  • Post-platinum: Pembrolizumab (category 1)
  • Post–checkpoint inhibitor, cisplatin ineligible, chemotherapy naïve: Gemcitabine/carboplatin
  • Post–checkpoint inhibitor, cisplatin eligible, chemotherapy naïve: Gemcitabine and cisplatin or DDMVAC (dose-dense methotrexate, vinblastine, doxorubicin [Adriamycin], cisplatin) with growth factor support

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