[Systemic therapy of muscle invasive bladder cancer - an update].

Urothelial cancer is a highly common tumor with increasing incidence worldwide and a peak in the seventh decade. Locally advanced disease has a significant risk for developing metastases. Neoadjuvant, platinum-containing combination chemotherapy improves survival over radical cystectomy. Chemotherapy with gemcitabine plus cisplatin shows equivalent efficacy with less toxicity to MVAC in metastatic setting. New therapy strategies, especially in elderly patients, are urgently needed.