[Advances in intravesical therapy for non-muscle-invasive bladder cancer]

Bladder cancer (BCa) is a common malignant tumor of the urinary system. Non-muscle-invasive bladder cancer (NMIBC) accounts for approximately 75% of newly diagnosed BCa cases. Transurethral resection of bladder tumor (TURBT) is currently the principal treatment for NMIBC; however, the postoperative recurrence rate remains high, making adjuvant pharmacological therapy an important component of treatment. In recent years, substantial advances have been made in pharmacological strategies for NMIBC, including immunotherapy, targeted therapy, and novel drug delivery systems. Immune checkpoint inhibitors (ICIs) have demonstrated definite efficacy in high-risk patients who are unresponsive to bacillus Calmette-Guérin. Antibody-drug conjugates (ADCs), such as RC-48, have shown favorable antitumor activity in selected patient populations. With regard to targeted therapy, erdafitinib has achieved breakthrough progress in patients with BCa harboring fibroblast growth factor receptor (FGFR) mutations or fusions. Novel drug delivery systems, such as the mitomycin-containing hydrogel formulation UGN-102, has been approved for marketing by the U.S. Food and Drug Administration (FDA). In addition, gene therapies such as nadofaragene firadenovec have entered clinical practice, while novel treatment modalities, including viral therapies, have progressed to the clinical trial stage. An in-depth understanding of the latest advances in intravesical therapy for NMIBC may provide evidence-based support for clinical decision-making and inform future combination and individualized treatment strategies.