Ravi Chauhan, MD, outlines practical considerations for nadofaragene in NMIBC

Urology Times® recently spoke with Ravi D. Chauhan, MD, FACS, at the 2025 LUGPA Annual Meeting, who highlighted the practical considerations for administering nadofaragene firadenovec (Adstiladrin) in clinical practice. Specifically, Chauhan outlined the convenient 3-month dosing schedule, the ease of administration compared with other options, and the importance of considering cost.

Chauhan is a urologist at the Conrad Pearson Clinic in Memphis, Tennessee.

Nadofaragene is an intravesical gene therapy that was approved in December 2022 for patients with high-risk BCG-unresponsive non–muscle invasive bladder cancer (NMIBC) with carcinoma in situ with or without papillary tumors. The agent is administered on a quarterly dosing schedule, which Chauhan said that patients tend to appreciate.

“Patients seem to think that it is a much more convenient treatment regimen,” Chauhan explained. “In fact, after getting loads of BCG once a week for 6 weeks and then once a week for 3 weeks on their maintenance schedule, when they hear that they only have to come in and get a dose every 3 months, they're very excited.”

Chauhan also touched on the cost of new therapies in the NMIBC space—which he says has hindered many practices from adopting them. However, he noted that there has been strong industry support to help overcome some of these challenges.