The role of gemcitabine-docetaxel in the management of NMIBC: a scoping review of current status and future directions.

INTRODUCTION: Intravesical sequential gemcitabine - docetaxel (Gem/Doce) has emerged as an important chemotherapeutic regimen in the management of non - muscle-invasive bladder cancer (NMIBC). It holds particular clinical significance in the context of high-risk NMIBC (HR-NMIBC) that either fails standard Bacillus Calmette - Guérin (BCG) immunotherapy or when BCG is contraindicated or unavailable. The combination leverages two cytotoxic agents with complementary mechanisms to achieve tumor eradication while aiming to preserve the bladder.

AREAS COVERED: This review explores the evidence for the use of intravesical Gem/Doce in NMIBC. We performed a scoping review of studies across BCG-naïve and BCG-unresponsive populations (MEDLINE, Embase, ClinicalTrials.gov; 2015-2025). Outcomes assessed included efficacy, adverse events, safety, and bladder preservation. We also discuss emerging data on novel delivery methods, maintenance strategies and combination regimens.

EXPERT OPINION: Intravesical Gem/Doce has transitioned from an experimental salvage approach to a promising mainstream option in NMIBC management. Current evidence indicates that intravesical Gem/Doce can achieve durable disease control in a substantial proportion of patients with HR-NMIBC, offering a well-tolerated and cost-effective bladder-sparing strategy. While the absence of randomized trials means Gem/Doce is not yet a formal standard of care, the accumulating clinical experience and supportive outcomes have led to its inclusion in contemporary treatment algorithms.