Current Therapy and Emerging Intravesical Agents to Treat Non-Muscle Invasive Bladder Cancer

Kelly K Bree; Nathan A Brooks; Ashish M Kamat

doi:10.1016/j.hoc.2021.02.003

Current Therapy and Emerging Intravesical Agents to Treat Non-Muscle Invasive Bladder Cancer

Hematol Oncol Clin North Am. 2021 Jun;35(3):513-529. doi: 10.1016/j.hoc.2021.02.003. Epub 2021 Apr 18.

Authors

Kelly K Bree¹, Nathan A Brooks¹, Ashish M Kamat²

Affiliations

¹ Department of Urology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
² Department of Urology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. Electronic address: AKamat@MDAnderson.org.

PMID: 33958148
DOI: 10.1016/j.hoc.2021.02.003

Abstract

Transurethral resection of bladder tumor remains the cornerstone of non-muscle invasive bladder cancer management, proper risk stratification, and appropriate selection of adjuvant therapy. A single, postoperative dose of intravesical chemotherapy is used for low-risk patients; patients with high-grade, high-risk disease should receive intravesical bacillus Calmette-Guérin (BCG) induction and maintenance therapy. For patients who develop BCG-unresponsive disease, cystectomy remains the standard of care. Pembrolizumab and valrubicin are approved in the BCG failure setting and as alternative treatments to cystectomy. Nadofaragene firadenovec, vicinium, hyperthermic chemotherapy, and various combination therapies are under investigation as treatment options for patients in the salvage setting.

Keywords: BCG failure; BCG naive; Intravesical therapy; Non–muscle invasive bladder cancer.

Publication types

Review

MeSH terms

Administration, Intravesical
BCG Vaccine / therapeutic use
Humans
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Salvage Therapy
Urinary Bladder Neoplasms* / drug therapy

Substances

BCG Vaccine