Joshua J. Meeks, MD, PhD, highlights dosing schedule advantage of nadofaragene in NMIBC

In this interview, conducted at the 2025 LUGPA Annual Meeting, Joshua J. Meeks, MD, PhD, the Edward M. Schaeffer, MD, PhD Professor of Urology and associate professor of urology, biochemistry, and molecular genetics at Northwestern University Feinberg School of Medicine in Chicago, Illinois, discusses the clinical and practical advantages of nadofaragene firadenovec (Adstiladrin) in the management of non–muscle invasive bladder cancer (NMIBC), particularly for patients who are unresponsive to BCG. He highlights that the therapy’s quarterly dosing schedule represents a significant improvement in convenience and workflow efficiency compared with traditional intravesical treatments.

Many existing therapies require patients to come in weekly for 6-week induction courses, which can be burdensome. In contrast, nadofaragene firadenovec’s every-3-month administration is far easier for both patients and clinical teams, enhancing adherence and overall patient satisfaction. Meeks notes that patients, who are often accustomed to frequent and intensive visits, find this extended interval highly appealing.

Looking forward, Meeks said he sees nadofaragene firadenovec as a promising addition to the NMIBC treatment landscape. Although it has been FDA-approved for some time, he explains that its integration into clinical practice is still relatively recent, and ongoing experience will help clarify its long-term role. He emphasizes the importance of monitoring the durability of patient responses over time, as sustained benefit could establish the drug as a viable long-term maintenance option or even as an alternative to cystectomy for certain individuals. Meeks also mentions the potential for retreatment in patients who exhibit persistent carcinoma in situ (CIS) and suggests that combination strategies could further expand its utility. Overall, he expresses optimism that, as clinical data and experience grow, nadofaragene firadenovec may provide durable remissions and meaningful quality-of-life advantages for patients with NMIBC, solidifying its place among evolving bladder-sparing therapeutic options.