The introduction of combination therapy - using both radiation and cisplatin chemotherapy together – offers an important new treatment alternative for patients with advanced bladder cancer who are older or otherwise unable to undergo bladder surgery. The strategy provides tumor shrinkage, limits nearby cancer growth, and enables many patients to retain normal bladder function – a key quality of life benefit.

In 2012, a Phase III study confirms the benefits of this approach, using the chemotherapy drugs fluorouracil and mitomycin. Researchers demonstrate this regimen improves survival, with no significant increase in side effects.

Researchers identify the first multi-drug chemotherapy regimen to extend survival for patients with advanced bladder cancer, offering cures in some cases. The regimen – called MVAC – involves a combination of the drugs methotrexate, vinblastine, doxorubicin, and cisplatin. Researchers later confirm that MVAC is superior to single-drug chemotherapy with cisplatin, although the combination regimen causes more side effects.

Cisplatin emerges as a standard chemotherapy drug for patients with bladder cancer, following results of several studies showing that the drug shrinks many bladder cancer tumors and, in some cases, induces cancer remissions. Later, combination chemotherapy using cisplatin together with other chemotherapy drugs becomes the cornerstone of bladder cancer treatment.

Researchers first establish that a specific form of early-stage bladder cancer, called carcinoma in situ (CIS) or noninvasive flat urothelial carcinoma, is a precursor to invasive bladder cancer. These early cancers grow in the layer of cells closest to the inside of the bladder and appear as flat lesions on its inside surface. When diagnosed early, doctors now know to treat CIS aggressively with surgery and other drug therapies. Left untreated, nearly a quarter of these early cancers will spread to the surrounding muscle and become far more difficult to cure.