Management of metastatic bladder cancer

Despite local therapy with curative intent, a substantial proportion of patients with invasive transitional cell carcinoma (TCC) of the bladder develop distant metastases during the course of their illness. Furthermore, a subset of patients presents with advanced disease at the time of initial diagnosis. Once the cancer is metastatic, the majority of patients succumb to their disease. As a result, intense efforts over the past two decades have focused on the development of active chemotherapeutic regimens for this disease.