@cann1, fellow members @onemaster and @sepdvm have experience with metastatic urothelial carcinoma and some of the same treatments you've had.

You ask a very good question - "if four different therapies have not stabilized my disease, what value is there in repeating the course of treatment?" so I pulled it into its own discussion.

Naturally, part of the response or decision depends on your personal choices and overall health status. I would want to weigh the side effects and quality of life against the likelihood of stabilizing or slowing progression. Here's some of the questions I would ask the cancer team:
- How might carboplatin/gem succeed where previous protocols have not?
- What are the potential side effects?
- How can they be managed and quality of life maintained?

@cann1, are you also in the care of a palliative care team to help manage side effects and your comfort?