TAR-200 is a DNA replication inhibitor. It is an intravesical, continuous-release form of the nucleoside analog chemotherapy agent gemcitabine.¹

Nogapendekin alfa inbakicept-pmin (NAI) is an interleukin-15 (IL-15) receptor agonist¹ and is often described as an IL-15 superagonist.² It binds to its receptor on the surface of CD-4+ and CD-8+ T cells and natural killer (NK) cells, leading to cell proliferation and activation, without stimulating the proliferation of immunosuppressive Treg cells.

ADSTILADRIN (Nadofaragene firadenovec-vncg) is a gene therapy leading to expression of interferon (IFN)α2b in uroepithelial cells. It is a nonreplicating adenoviral vector containing the cDNA for IFNα2b. Intravesical administration leads to prolonged (at least 7 days) expression of IFNα2b in tumor and uroepithelial cells. IFNα2b is believed to have pleiotropic effects including direct cytotoxic effects in tumor cells, antiangiogenic effects, and increased expression of tumor-associated antigens. It also modulates the immunologic properties of the tumor microenvironment, enhancing both innate and adaptive antitumor immunity.¹

KEYTRUDA (pembrolizumab) is a programmed death receptor-1 (PD-1) blocking antibody. Some tumors express PD-1 ligands (PD-L 1 or PD-L 2) allowing them to bind PD-1 on T cells. This interaction inhibits T-cell proliferation and cytokine production, thereby inhibiting the T-cell response to tumor cells. Pembrolizumab (intravenous) blocks this interaction by binding to PD-1, thereby permitting the antitumor T-cell response.¹

Incompletely understood, but BCG is believed to trigger immune responses leading to cytotoxicity against bladder cancer cells.¹