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Bladder cancer is one of the most common cancers among men and women, with men being twice as likely affected from the disease (Jemal et al., 2005). The most common type of bladder cancer is transitional cell carcinoma (TCC), which is derived from the urothelium and constitutes more than 90 % of all bladder cancers (Bischoff & Clark, 2009). Cisplatinbased combination therapy is the standard therapy for the treatment of advanced or metastatic bladder cancers (Cohen et al., 2006, Kaufman, 2006). However, the outcome of patients with metastatic bladder cancer remains poor, as tumors become resistant to cisplatin therapy. It is still not entirely known, which factors influence the response of bladder cancers to the drug and how this cancer acquires cisplatin resistance. Cisplatin is a neutral planar complex (Figure 1A).

The Molecular Basis of Cisplatin Resistance in Bladder Cancer Cells