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Narrative Review of Potential Non-Surgical Treatments for BCG-Unresponsive Non-Muscle Invasive Bladder Cancer
Sung Han Kim1, Haarika Gudlavalleti1, Seth P Lerner1
1Scott Department of Urology, Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA.
Journal of Clinical Medicine
|May 27, 2026
Summary
Bacillus Calmette-Guérin (BCG) therapy is standard for non-muscle invasive bladder cancer (NMIBC). This review explores bladder preservation strategies for BCG-unresponsive NMIBC, offering alternatives to radical cystectomy.
Area of Science:
- Oncology
- Urology
Background:
- Intravesical Bacillus Calmette-Guérin (BCG) is a standard treatment for non-muscle invasive bladder cancer (NMIBC).
- BCG resistance leads to recurrence and progression, often necessitating radical cystectomy.
- Radical cystectomy significantly impacts quality of life and carries surgical risks.
Purpose of the Study:
- To review established and novel therapeutic agents for bladder preservation in NMIBC.
- To evaluate the efficacy of various agents and combination regimens.
- To identify alternatives to radical cystectomy for BCG-unresponsive NMIBC.
Main Methods:
- Systematic review of established therapeutic agents.
- Exploration of ongoing clinical trials for new agents and interventions.
- Analysis of prognostic efficacy and therapeutic advantages of different regimens.
Main Results:
- BCG resistance is a significant challenge in NMIBC management.
- Bladder preservation strategies offer potential alternatives to cystectomy.
- Combined therapeutic regimens may improve outcomes for BCG-unresponsive NMIBC.
Conclusions:
- Bladder preservation is a viable concept for managing BCG-unresponsive NMIBC.
- Further research into novel agents and combination therapies is crucial.
- Improving treatment efficacy can help retain the bladder and enhance patient quality of life.
