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Doctor discussing intravesical therapy with patient

Intravesical therapy is a viable treatment option for some patients with non-muscle invasive bladder cancer (NMIBC)—an early-stage cancer that is confined to the lining of the bladder and has not yet spread to deeper tissues. During intravesical therapy, immunotherapy or chemotherapy drugs in liquid form are fed directly into the bladder through a soft catheter instead of taken orally or intravenously. This approach helps maximize the effectiveness of treatment while minimizing potential side effects, since the drugs don’t have to travel through other areas of the body to reach the bladder.

Gemcitabine and docetaxel are chemotherapy drugs that may be delivered to the bladder through intravesical therapy. 

  • Gemcitabine (Gemzar®) is an antimetabolite, a type of drug that disrupts a cancer cell’s ability to divide by attacking certain substances within the cell during specific phases of the division process.
  • Docetaxel (Taxotere®) is a plant-derived, antimicrotubule agent that hinders a cancer cell’s ability to replicate itself by interfering with microtubule structures inside the cell. 

Gemcitabine is the first drug administered in this form of intravesical therapy, followed immediately by docetaxel. While intravesical chemotherapy is associated with significantly fewer side effects than oral or intravenous chemotherapies, some patients may notice bladder irritation, burning sensations or blood in urine following treatment.

When is intravesical therapy with gemcitabine and docetaxel recommended?

Intravesical chemotherapy with gemcitabine and docetaxel is rarely a first-line treatment for bladder cancer. Surgery to remove bladder tumors (transurethral surgery) or all or part of the bladder (cystectomy) is often recommended before trying other approaches. Still, gemcitabine and docetaxel may be appropriate for patients who aren’t ideal candidates for surgery or who want to preserve their bladder, if possible. 

Gemcitabine and docetaxel delivered through intravesical therapy are typically recommended to patients who do not respond well to bacillus Calmette-Guerin (BCG) treatment, a more common type of intravesical therapy that uses immunotherapy drugs to disrupt the processes that fuel bladder cancer growth. When BCG treatment is not effective—an occurrence referred to as BCG failure—intravesical therapy with gemcitabine and docetaxel may then be administered.

Bladder cancer treatment at Moffitt Cancer Center

Moffitt Cancer Center's Urologic Oncology Program is home to a multispecialty team that excels in providing a diverse range of treatments for bladder cancer, including intravesical immunotherapies and chemotherapies with gemcitabine and docetaxel as well as minimally invasive robotic procedures. Ranked in the top 1% of cancer centers by national experts, Moffitt takes an individualized approach to treatment that focuses on each patient's unique diagnosis, health needs and treatment preferences. Furthermore, Moffitt is the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida—a distinction that points to our unwavering commitment to research and innovation.

Individuals who’d like to receive a second opinion or discuss bladder cancer treatment options with a Moffitt oncologist can call 1-888-663-3488 or submit a new patient registration form online without a referral. Bladder cancer clinical trials may also be available to eligible patients.