title: Non-muscle-invasive bladder cancer: Intravesical treatments beyond Bacille Calmette-Guérin.
abstract: An unmet need exists for patients with high-risk non-muscle-invasive bladder cancer for whom bacille Calmette-Guérin (BCG) has failed and who seek further bladder-sparing approaches. This shortcoming poses difficult management dilemmas. This review explores previously investigated first-line intravesical therapies and discusses emerging second-line treatments for the heterogeneous group of patients for whom BCG has failed. The myriad of recently published and ongoing trials assessing novel salvage intravesical treatments offer promise to patients who both seek an effective cure and want to avoid radical surgery. However, these trials must carefully be contextualized by specific patient, tumor, and recurrence characteristics. As data continue to accumulate, there will potentially be a role for these agents as second-line or even first-line intravesical therapies. Cancer 2017;123:390-400. © 2016 American Cancer Society.
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Vignesh T
authors.initials: VT
authors.lastname: Packiam
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Johnson
authors.affiliation: Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Gary D
authors.initials: GD
authors.lastname: Steinberg
mesh_terms: D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000009:adverse effects / Q000627:therapeutic use; D019468:Disease Management; D005260:Female; D006801:Humans; D007167:Immunotherapy; D009361:Neoplasm Invasiveness / Q000235:genetics / Q000276:immunology; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D016879:Salvage Therapy / Q000379:methods*; D017211:Treatment Failure; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology
chemical_list: D001500:BCG Vaccine
keywords: bacille Calmette-Guérin (BCG); bladder-sparing; chemotherapy; immunotherapy; intravesical; non-muscle-invasive bladder cancer; urothelial neoplasms