
Opinion|Videos|May 22, 2025
An Overview Of Pembrolizumab for High-Risk BCG Unresponsive NMIBC
Panelists discuss how pembrolizumab, a PD-1 inhibitor, offers a systemic immunotherapy option for high-risk, BCG-unresponsive non–muscle-invasive bladder cancer (NMIBC) by enhancing the immune system’s ability to target cancer cells, with intravenous administration and careful monitoring for immune-related adverse effects.
Advertisement
Episodes in this series

Physician Summary:
Pembrolizumab (Keytruda)
- Mechanism of Action: Pembrolizumab is a PD-1 inhibitor that works by blocking the interaction between the PD-1 receptor on T cells and its ligands (PD-L1/PD-L2) on tumor cells. This enhances the immune system’s ability to recognize and attack cancer cells, particularly effective in treating carcinoma in situ and in cases with or without papillary tumors in BCG-unresponsive NMIBC.
- Administration: Unlike intravesical treatments, pembrolizumab is administered intravenously, typically every 3 weeks. This systemic approach allows it to target tumors throughout the body but requires careful monitoring for potential immune-related adverse effects.
Pembrolizumab offers a novel approach to managing high-risk, BCG-unresponsive NMIBC by harnessing the power of immunotherapy. Its ability to selectively block immune checkpoint signaling makes it effective in cases where traditional therapies fail.
Advertisement
Related to this article

The combination of nogapendekin alfa inbakicept plus BCG demonstrated a statistically significant improvement in efficacy vs BCG alone.

These FAQs outline key recommendations from ASTRO's updated guideline on shorter-course radiation therapy for localized prostate cancer.

Patient goals, disease features, and response to prior therapy guide treatment choices across high-risk NMIBC, according to Suzanne B. Merrill, MD, FACS.

Suzanne B. Merrill, MD, discusses emerging perioperative approaches in MIBC and the potential for more personalized treatment selection based on disease characteristics.

BCG monotherapy and a high-quality TURBT remain the foundation for BCG-naive high-risk NMIBC, according to Vignesh T. Packiam, MD.

Independent urology practices head into 2027 facing a conversion factor cut, prior authorization hurdles, and Part B drug price negotiation, according to Gary Kirsh, MD.
Advertisement
Advertisement
Trending on Urology Times
1
Patient priorities guide treatment choice in BCG-unresponsive NMIBC
2
Pasritamig combination yields 73% PSA response rate in phase 1 mCRPC study
3
FAQ: ASTRO guideline on hypofractionated radiation therapy for localized prostate cancer
4
Nogapendekin alfa inbakicept plus BCG meets primary end point in BCG-naïve NMIBC
5


