Palliative systemic treatment of bladder cancer

Abstract

The systemic treatment of the bladder cancer is challenging. It is so due to moderate efficacy of chemotherapy and because of the restrictions secondary to the patient’s general performance status as well as an inadequate organ function (mainly renal function). The standards of the first line systemic treatment are established. The chemotherapy regimens containing platine derivates (preferably cisplatine) such as PG or MVAC are administered routinely. However such standard regarding the second line of systemic treatment is not defined. this reflects the lack of reliable scientific evidence supporting the chemotherapy use at this stage of the disease. Among several drugs being considered as the second line chemotherapy it is only vinflunine that proved its activity in phase III clinical trial and compared to the best supportive care improves prognosis and positively influence the quality of life.