title: Novel therapeutics in metastatic bladder cancer.
abstract: BACKGROUND
  Albeit transitional cell carcinoma of the urinary bladder is a chemosensitive neoplasm, metastatic disease is related with poor prognosis and short-term survival data.
  
  
  OBJECTIVE
  Cisplatin-based combination chemotherapy is recognised as the golden standard therapy for patients with inoperable locally advanced or metastatic bladder cancer. However, owing to treatment-related toxicities and short-response durations, novel treatment options or agents, with both enhanced efficacy and tolerability, have been sought.
  
  
  METHODS
  Reviewing the current status and addressing the future of novel anticancer therapeutics in metastatic urinary bladder cancer.
  
  
  CONCLUSIONS
  Non-platinum, single agents, such as gemcitabine and taxanes, as well as multidrug regimens in doublet or triplet chemotherapeutic combinations are regarded as promising alternatives. Dose intensification of conventional regimens, dose-dense sequential administration of new agents, the use of molecular markers for predicting chemosensitivity and the integration of biologically targeted agents to enhance chemotherapeutic efficacy are promising approaches.
authors.affiliation: National and Kapodistrian University of Athens, Sismanoglio General Hospital, Medical School, 2nd Department of Urology, Athens, Greece.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Lekas
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Papathomas
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Papatsoris
authors.forename: Charalambos
authors.initials: C
authors.lastname: Deliveliotis
authors.forename: Andreas C
authors.initials: AC
authors.lastname: Lazaris
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006801:Humans; D009362:Neoplasm Metastasis / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D017671:Platinum Compounds / Q000627:therapeutic use; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D017671:Platinum Compounds