How do you define cisplatin ineligibility for muscle invasive bladder cancer?

We traditionally have been using the "Galsky criteria" published in 2011 based on consensus.

We have looked into possibly lower threshold for estimated GFR, e.g. 50 ml/min, and possibly cisplatin "split dose" on a per patient basis if otherwise a patient is fit: Koshkin et al., PMID 29576445.

Sometim...