Urothelial carcinoma of urinary bladder occurs mainly in men at older ages. Although non-invasive disease carries an excellent prognosis, %25 patients with muscle invasive disease present with metastasis or develop systemic involvement during follow-up. Systemic chemotherapy is the standard approach for metastatic bladder cancer. The standard treatment alternatives and also molecularly targeted therapy options that will take part in the future management of bladder cancer are reviewed in this article. Regarding the present data, cisplatin based chemotherapy options should be the first choice for patients with good performance status whereas carboplatin could be preferred for the others. In the second line treatment, there is not a present randomised study to confirm the superiority of any agent over best supportive care whereas vinflunin with the only phase III study has became the standard second-line in Europe. Ongoing studies about molecularly targeted drugs and standart chemotherapy combinations will clarify the exact role of these drugs in the future management of bladder cancer.

Keywords: Metastatic bladder cancer, chemotherapy, molecularly targeted drugs