Chemotherapeutic options for cisplatin-ineligible patients with advanced carcinoma of the urothelium.

Advanced urothelial carcinoma is an aggressive form of cancer associated with a high mortality rate. Cisplatin-based chemotherapy regimens have improved survival of patients with this disease. A significant number of patients with urothelial carcinoma have impaired renal or cardiac function, poor performance status, or other comorbidities that preclude the use of cisplatin-based therapy. This review discusses alternative treatment regimens that have been evaluated to identify effective and less toxic therapeutic strategies for cisplatin-ineligible patients, as well as ongoing clinical trials that focus on this patient population.