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.