Opinion|Videos|February 5, 2025
Selecting Treatment for BCG-Unresponsive NMIBC
Author(s)Mark D. Tyson, MD, MPH, Gary D. Steinberg, MD
Panelists discuss how for patients with BCG-unresponsive bladder cancer, treatment selection depends on key factors including tumor characteristics (carcinoma in situ vs papillary), patient fitness, and preferences. Standard options include radical cystectomy (the gold standard) or bladder-preserving approaches such as pembrolizumab, intravesical chemotherapy, or clinical trials. The decision requires careful individualization based on risk stratification, comorbidities, and shared decision-making.
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Video content above is prompted by the following:
- How do you decide which therapy to use in patients with BCG-unresponsive disease?
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Related to this article
The combination of nogapendekin alfa inbakicept plus BCG demonstrated a statistically significant improvement in efficacy vs BCG alone.
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.
Patient priorities and practice logistics should guide therapy selection in BCG-unresponsive NMIBC, according to Katie S. Murray, DO, MS, FACS.
Systemic therapy now anchors MIBC care and expands bladder preservation options, according to Joshua J. Meeks, MD, PhD.
BCG optimization should precede checkpoint inhibitor intensification in BCG-naive high-risk NMIBC, according to Tom Jayram, MD.
The phase 1 study is intended to characterize the safety, tolerability, and feasibility of intravesical administration of UGN-501.
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