title: BCG-unresponsive non-muscle-invasive bladder cancer: recommendations from the IBCG.
abstract: Intravesical immunotherapy with live attenuated BCG remains the standard of care for patients with high-risk and intermediate-risk non-muscle-invasive bladder cancer (NMIBC). Most patients initially respond, but recurrence is frequent and progression to invasive cancer is a concern. No established and effective intravesical therapies are available for patients whose tumours recur after BCG, representing a clinically important unmet need. Development and discovery of treatment options for BCG-unresponsive NMIBC is a high priority in order to decrease the morbidity, burden of health-care expenditures, and mortality related to bladder cancer. This Review of treatment options after BCG failure focuses on principles of optimal management emerging therapies, thus enabling a synthesis of recommendations for management for such patients.
authors.affiliation: Department of Urology, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1373, Houston, Texas 77054, USA.
authors.forename: Ashish M
authors.initials: AM
authors.lastname: Kamat
authors.affiliation: Department of Urology, Claude Bernard University, Hôpital Edouard Herriot, Urologie - Pavillon V, 5 Place d'Arsonval, 69003 Lyon, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Colombel
authors.affiliation: Department of Urology, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1373, Houston, Texas 77054, USA.
authors.forename: Debasish
authors.initials: D
authors.lastname: Sundi
authors.affiliation: Department of Surgery, University of Arizona and BCG Oncology, 3815 East Bell Road, Suite 1210, Phoenix, Arizona 85032, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Lamm
authors.affiliation: Department of Urology, HELIOS Agnes Karll Hospital, Am Hochkamp 21, 23611 Bad Schwartau, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Boehle
authors.affiliation: Department of Urology, AUSL Modena, B. Ramazzini Hospital, Via G. Molinari, 1, 41012 Carpi-Modena, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Brausi
authors.affiliation: Department of Urology, North York General Hospital, 1333 Sheppard Avenue East, Suite 222, North York, Ontario M2J 1V1, Canada.
authors.forename: Roger
authors.initials: R
authors.lastname: Buckley
authors.affiliation: Department of Urology/Surgery, Southmead Hospital &Bristol Urological Institute, Brunel Building, Southmead Road, Bristol BS10 5NB, UK.
authors.forename: Raj
authors.initials: R
authors.lastname: Persad
authors.affiliation: Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Carrer de Cartagena, 340-350, 08025 Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Palou
authors.affiliation: Division of Urologic Oncology, Memorial Cancer Institute, Memorial Health System, 20801 Biscayne Boulevard, Suite 203, Aventura, Florida 33180, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Soloway
authors.affiliation: Department of Urology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HGB, Nijmegen, Netherlands.
authors.forename: J Alfred
authors.initials: JA
authors.lastname: Witjes
mesh_terms: D000283:Administration, Intravesical; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001500:BCG Vaccine / Q000008:administration & dosage*; D006801:Humans; D007167:Immunotherapy / Q000379:methods / Q000592:standards; D038622:Internationality; D009361:Neoplasm Invasiveness / Q000473:pathology / Q000517:prevention & control; D012955:Societies, Medical / Q000592:standards*; D017211:Treatment Failure; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D001500:BCG Vaccine