Chemotherapy for Muscle-Invasive Bladder Cancer
Chemotherapy (also called chemo) uses drugs to destroy or damage fast-growing cells like cancer cells. It is used to shrink tumors, slow cancer’s growth, relieve symptoms, or help people live longer. Chemotherapy drugs are given in different ways (intravenously, orally by a pill, or by injection).
Chemotherapy is most often given before surgery. This is called neoadjuvant (NEE-oh-AD-joo-vant) chemotherapy. Studies show that neoadjuvant therapy before radical cystectomy improves survival. Chemotherapy may also be given after surgery. This is called adjuvant chemotherapy. This is often done to try to kill any cancer that may have spread to other parts of the body.
These are the latest chemotherapy drugs that are approved to treat muscle-invasive bladder cancer. New treatments become available all the time, so this may not be a complete list.
Please note: The side effects listed here do not represent a comprehensive list. It's important to discuss all potential side effects of a drug with your healthcare team. Be sure to tell your healthcare team about any side effects you do have.
All Available Treatments
IV or Injection = 
Pill = 
Treatment Type
Antitumor Antibiotic
Drug Name
Important Things to Know
This medication can be given alone or in combination with fluorouracil.
- Low blood counts are a potential side effect that may put you at risk for anemia, infection, or bleeding.
- Mouth sores are a potential side effect that can be painful and affect your oral intake. Speak to your provider about proactive management and an oral care regimen.
- When used as intravesical therapy, bladder irritation may occur.
Treatment Type
Antimetabolite
Drug Names
Potential Side Effects - Adrucil
Diarrhea
Low blood counts
Nausea/vomiting
Taste changes
Weight/appetite changes
Potential Side Effects - Gemzar
Flu-like symptoms
Low blood counts
Nausea/vomiting
Skin/nail changes
Weight/appetite changes
Important Things to Know
- Adrucil can be given in combination with cisplatin or mitomycin.
- Adrucil only: Discoloration along the vein could occur with this infusion. If this occurs, discuss it with your health care team so they can evaluate it.
- Gemzar can be given alone or in combination with paclitaxel.
- Otrexup is given in the ddMVAC regimen or CMV regimen.
- Low blood counts are a potential side effect that may put you at risk for anemia, infection, or bleeding.
- Mouth sores are a potential side effect of Otrexup that can be painful and affect your oral intake. Speak to your provider about proactive management and an oral care regimen.
Treatment Type
Anthracycline Antibiotic
Drug Name
Important Things to Know
- This medication is given in the ddMVAC treatment regimen.
- Low blood counts are a potential side effect that may put you at risk for anemia, infection, or bleeding.
Treatment Type
Alkylating Agent
Drug Name
Important Things to Know
- Low blood counts are a potential side effect that may put you at risk for anemia, infection, or bleeding.
- This medication is given in the ddMVAC treatment regimen, CMV regimen, or in combination with fluorouracil.
- Damage to the kidneys is a potential side effect.
Treatment Type
Plant Alkaloid
Drug Names
Potential Side Effects - Taxol
Diarrhea
Hair thinning/loss
Joint pain/stiffness
Low blood counts
Mouth sores
Nausea/vomiting
Neuropathy
Important Things to Know
- These medications are given through an IV or as an injection.
- Alkaban-AQ is given in the ddMVAC regimen or CMV regimen.
- Taxol is given in combination with gemcitabine.
- Low blood counts are a potential side effect that may put you at risk for anemia, infection, or bleeding.
- Mouth sores are a potential side effect of Taxol that can be painful and affect your oral intake. Speak to your provider about proactive management and an oral care regimen.