Jen-Jane Liu, MD, highlights clinical advantages of detalimogene voraplasmid in NMIBC

In this video, Jen-Jane Liu, MD, an associate professor of urology at the Oregon Health & Science University School of Medicine in Portland, discusses the emerging role and potential advantages of detalimogene voraplasmid, an investigational intravesical gene therapy for non–muscle invasive bladder cancer (NMIBC), particularly in patients with BCG-unresponsive carcinoma in situ (CIS).

Liu notes that current data—showing a response rate of just over 50%—indicate that the BCG-unresponsive CIS cohort is the most appropriate initial target population. This group has historically responded well to immune-mediated intravesical therapies like BCG, aligning with the immune-based mechanism of detalimogene voraplasmid. Although future data on papillary disease cohorts will be important, she said she does not expect higher efficacy in those patients, given the distinct biology of non-muscle invasive disease with papillary features.

From a logistical standpoint, Liu highlights several practical advantages of detalimogene voraplasmid compared with BCG. The therapy is stored at room temperature, avoiding the need for deep freezing or complex handling. It is not a live vaccine or chemotherapeutic agent, simplifying preparation and safety procedures. The product is supplied as a powder reconstituted with water, with a 1-hour dwell time, and is administered in a 4-week cycle with a 1-week break, repeated every 3 months. These features make treatment more accessible and convenient for both patients and providers, potentially improving adherence and reducing travel burdens.

Liu also contrasts community and academic settings in implementing detalimogene voraplasmid. Community urologists, who manage most NMIBC cases, often lack infrastructure for chemotherapy or complex gene therapies. Detalimogene voraplasmid’s ease of use and storage could make it particularly appealing for office-based administration, expanding access to effective bladder cancer therapy within local communities while reducing reliance on tertiary care centers.