Gemcitabine and Split-dose Cisplatin (GC) Plus Sorafenib in Chemotherapy-naïve Patients With Locally Advanced or Metastatic Urothelial Carcinoma

Inclusion Criteria: * Patients must have measurable or evaluable urothelial cancer. * Measurable disease includes unresectable or metastatic urothelial tract tumors that are unidimensionally measurable by xray,CT/MRI scan or physical examination. * Evaluable disease is restricted to patients with unresectable primary bladder tumors which can be evaluated for response by cystoscopy. * Pathologic confirmation by the Department of Pathology at MSKCC. * Karnofsky Performance Status (KPS) ≥60%. * Adequate marrow function defined as granulocytes ≥ 1500 cells/mm 3 , platelets ≥ 100,000 cells/mm 3 , and hemoglobin ≥ 8.0 g/dl. * Serum creatinine \< 2.0 mg/dl * 24-hour urine sample demonstrating creatinine clearance ≥ 60 ml/min/1.73m2 or calculated creatinine clearance ≥ 60 ml/min/1.73m 2 using the formula: Jeliffe Equation: estimated creatinine clearance = 98 x (0.8 \[age(yrs) 20\]/Serum Creatinine (mg/dL) x (0.9 if Female)) * Adequate hepatic function defined as: * Total Bilirubin \< or = to 1.5 x ULN * AST and ALT \< or = to 3.0 x ULN (\< or = to 5.0 x ULN is acceptable if liver has tumor involvement) * Normal coagulation profile including PT/INR and PTT, unless patient is receiving anticoagulation therapy with agents such as warfarin or heparin. * Age ≥ 18 years * Informed consent * Women of childbearing potential must have a negative pregnancy test. * Men and women of childbearing potential must be willing to consent to using effective contraception while on treatment and for at least 3 months thereafter. * Patients are encouraged to continue barrier method contraception for two years or longer after treatment. Exclusion Criteria: * Prior treatment with systemic chemotherapy (prior intravesical therapy is permitted). * Current, recent (within 4 weeks of the first infusion of this study), or planned participation in an experimental drug study. * Blood Pressure of \> 150/100 mm Hg. * Irradiation within 4 weeks of start of protocol. * Evidence of another active cancer, except for nonmelanoma skin carcinoma, insitu carcinoma of the cervix curatively treated, and adenocarcinoma of the prostate that has been surgically treated with a post-treatment PSA that is nondetectable. * Significant cardiovascular disease including congestive heart failure (New York Heart Association Class II or higher) or active angina pectoris. * History of a myocardial infarction within 6 months. * History of a stroke or transient ischemic attack within 6 months. * Clinically significant peripheral vascular disease. * Evidence of bleeding diathesis or coagulopathy. * Presence of central nervous system or brain metastases. * Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to Day 0. * Minor surgical procedures such as fine needle aspirations or core biopsies within 7 days prior to Day 0. * History of abdominal fistula, gastrointestinal perforation, or intraabdominal abscess within 6 months prior to Day 0. * Serious nonhealing wound, ulcer, or bone fracture. * History of persistent gross hematuria. * Uncontrolled infection. * Hypersensitivity to sorafenib, or any component of the formulation. * Pregnant (positive pregnancy test) or lactating. * Inability to comply with the study and/or followup procedures.