Summary for doctors
- Advanced disease (when EV-pembrolizumab is not the choice) and before cystectomy [1].
- Cisplatin-eligible: creatinine clearance 60 or more, ECOG 0 to 1, no grade 2 neuropathy or hearing loss, and no heart failure.
- After response or stable disease in advanced disease: maintenance avelumab [2].
Dose and schedule
Gem/Cis
Advanced urothelial cancer or before surgeryCycle length: Every 28 days
Advanced urothelial cancer or before surgery
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Gemcitabine | 1000 mg/m² | IV | Days 1, 8 and 15 |
| Cisplatin | 70 mg/m² | IV | Day 2 |
Schedule as in von der Maase [1]. Many centres use a 21-day schedule (gemcitabine on days 1 and 8, cisplatin on day 1).
Maintenance avelumab
After 4 to 6 cycles of platinum chemotherapy without progressionCycle length: Every 14 days
After 4 to 6 cycles of platinum chemotherapy without progression
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Avelumab | 10 mg/kg (or 800 mg) | IV | Day 1 |
As in JAVELIN Bladder 100 [2]; antihistamine and paracetamol premedication for the first 4 doses.
Dose source: [3].
Evidence: JAVELIN Bladder 100 (2020)
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Premedication and supportive care
- Hydration and magnesium with cisplatin; highly emetogenic antiemetics.
- With borderline creatinine clearance, split-dose cisplatin (35 on days 1 and 8) or carboplatin in advanced disease.
Monitoring and dose adjustment
- Blood counts before each gemcitabine dose; creatinine and hearing.
Main evidence
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Gemcitabine-cisplatin gave survival similar to MVAC (about 14 months) with less toxicity [1]. JAVELIN Bladder 100: maintenance avelumab increased median survival from 14.3 to 21.4 months [2].
Related cancer types
Treatment regimens (physicians)
References
3 referencesShow all references, 1 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
- 1
- 2
- 3BAVENCIO (AVELUMAB) — Prescribing Information
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/gemcitabine-cisplatin-bladder/