Therapeutic approaches including interferon to carcinoma in situ of the bladder

The management of CIS of the bladder consists of two complementary but separate therapeutic goals: treatment of existing disease and the prevention of recurrence. At present the biological behavior and prognosis of CIS remains to be completely defined. To date, the majority of experience with the medical management of CIS of the bladder is with chemotherapeutic agent doxorubicin and the immunotherapeutic agent BCG. Other agents such as mitomycin and interferon appear promising. The efficacy of these drugs will have to be evaluated in prospective randomized trials. At that time a number of questions should be answered concerning the treatment of CIS of the bladder: what is the effect of these agents on morbidity and survival, what is the optimal dose, schedule, and duration of therapy for these drugs, and will the biology of the disease, e.g. extravesical recurrences mandate systemic therapy?