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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11228680 | PMC |
| http://dx.doi.org/10.21037/tau-23-630 | DOI Listing |
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The Evolving Landscape of Systemic Immunotherapy for Bacillus Calmette-Guérin-naïve High-risk Non-muscle-invasive Bladder Cancer: At the Edge of a Tsunami?
Eur Urol Oncol
August 2025
Department of Urology, Bichat Claude-Bernard Hospital, Assistance Publique - Hôpitaux de Paris Nord, University Paris Cité, Paris, France. Electronic address:
Background And Objective: Treatment options for high-risk (HR) non-muscle-invasive bladder cancer (NMIBC) are still limited. The addition of systemic immunotherapy to intravesical bacillus Calmette-Guérin (BCG) instillations is currently being explored as an initial strategy for BCG-naïve HR NMIBC patients to enhance treatment effectiveness and decrease the risk of BCG failure.
Methods: A collaborative narrative review of the literature by the Cancer Committee of the French Association of Urology (CC-AFU) was carried out to describe ongoing studies assessing systemic immunotherapy in BCG-naïve HR NMIBC patients, focus on the different study designs, and evaluate the clinical pertinence of the endpoints.
Traditional and next-generation bacillus Calmette-Guérin based treatment strategies for bacillus Calmette-Guérin unresponsive non-muscle-invasive bladder cancer in the era of emerging therapies.
Curr Opin Urol
July 2025
Department of Urology, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcala, Madrid.
Purpose Of Review: Bacillus Calmette-Guérin (BCG) remains the standard of care for high-risk non-muscle-invasive bladder cancer (NMIBC), yet up to 40-50% of patients experience treatment failure, leaving limited alternatives to avoid radical cystectomy. This narrative review critically examines both traditional and emerging BCG-based strategies - including repeat induction and modern combination regimens - for patients with BCG-unresponsive NMIBC.
Recent Findings: BCG monotherapy after BCG failure has shown limited effectiveness, with recent studies reporting 12-month disease-free survival (DFS) rates of 60-70%.
Efficacy and safety of BCG and immune checkpoint inhibitors in non-muscle invasive bladder cancer: A meta-analysis with exploratory chemotherapy comparisons.
Oncol Lett
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Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, P.R. China.
Bladder cancer (BC) is a significant global health concern and includes non-muscle-invasive BC (NMIBC), which poses challenges due to recurrence and progression. Immunotherapy, such as immune checkpoint inhibitors (ICIs) and Bacillus Calmette-Guérin (BCG), shows promise particularly in cases of BCG failure or BCG-unresponsive NMIBC, with ICIs emerging as a potential treatment option for these challenging cases. To the best of our knowledge, the present study is the first to systematically compare the efficacy and safety of BCG with ICIs in NMIBC.
View Article and Find Full Text PDFUrine Tumor DNA to Stratify the Risk of Recurrence in Patients Treated with Atezolizumab for Bacillus Calmette-Guérin-unresponsive Non-muscle-invasive Bladder Cancer.
Eur Urol
May 2025
University of British Columbia, Vancouver, BC, Canada. Electronic address:
As new treatments for bacillus Calmette-Guérin (BCG)-unresponsive non-muscle-invasive bladder cancer (NMIBC) emerge, better methods are needed to guide therapeutic decisions. This study analyzed urine tumor DNA (utDNA) from patients treated with atezolizumab in the SWOG S1605 trial to determine whether utDNA profiling can stratify the risk of treatment failure. Urine samples were analyzed using the UroAmp assay at baseline and 3 mo from 89 and 77 patients, respectively.
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Front Immunol
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Department of Emergency, The First People's Hospital of Xiaoshan District, Hangzhou, China.
Bladder cancer is a prevalent malignancy, with muscle-invasive bladder cancer (MIBC) presenting a significant therapeutic challenge. Standard treatments, including radical cystectomy (RC) and neoadjuvant chemotherapy, pose substantial risks and impact quality of life, leading to increasing interest in bladder-preserving therapies (BPT). Immunotherapy has revolutionized bladder cancer management, with strategies ranging from intravesical Bacillus Calmette-Guérin (BCG) to immune checkpoint inhibitors targeting programmed cell death protein 1 (PD-1) and its ligand (PD-L1).
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