Topline Data From the BOND-003 Trial in NMIBC

EP: 1.Current Standards of Care and Shifting Strategies in NMIBC

EP: 2.NMIBC Treatment Decisions in the Age of BCG Shortages

EP: 3.Expert Discussion on BCG-Unresponsive NMIBC

EP: 4.Bladder-Sparing Breakthroughs: Novel FDA-Approved Treatment Options for NMIBC

EP: 5.Weighing the Risks and Benefits of Bladder-Sparing Agents vs Cystectomy

EP: 6.What’s Next for NMIBC: The Immunotherapy and Gene Therapy Pipeline

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EP: 7.Topline Data From the BOND-003 Trial in NMIBC

EP: 8.Immunotherapy in NMIBC: Key Results Safety Profile From BOND-003 Trial

EP: 9.Diving Deeper: Discussing Results From Cohort C in the BOND-003 Trial

EP: 10.Ongoing Investigations: Expanding the Role of Cretostimogene in NMIBC Care

EP: 11.In the Pipeline: Novel Treatment Delivery Methods for NMIBC

EP: 12.Rethinking First-Line Treatments: Will BCG Continue to Be the Standard in NMIBC?

Recent developments in the treatment of BCG-unresponsive non–muscle-invasive bladder cancer have introduced a variety of immunotherapy approaches aimed at improving outcomes. One promising strategy involves the combination of BCG with PD-1 or PD-L1 inhibitors. Preclinical data suggest that BCG upregulates PD-L1 expression on bladder cancer cells, which can enhance the tumor’s susceptibility to checkpoint blockade. One subcutaneously administered PD-1 inhibitor was recently studied in this context, showing high initial complete response rates and promising durability. However, these benefits came with increased systemic toxicity and a notable incidence of serious immune-related adverse events, raising questions about the overall risk-benefit balance.

While early data are encouraging, the adoption of these therapies in routine practice remains cautious. The systemic nature of checkpoint inhibitors introduces complexities, particularly for urologists who may not have the infrastructure or expertise to manage serious immune-related toxicities such as colitis, pneumonitis, or endocrinopathies. This raises concerns about patient safety, especially in settings where medical oncology support is limited. Additionally, some experts question whether it is appropriate to expose patients with localized disease to potentially severe systemic adverse effects when there are already bladder-sparing options with more favorable safety profiles. There is general consensus that such treatments may be reserved for patients with the highest risk profiles or those who have failed multiple other therapies.

Ultimately, the decision to use intravesical or systemic immunotherapy must be individualized, balancing potential oncologic benefits against toxicity risks. For now, many clinicians may limit use of systemic PD-1 inhibitors to select high-risk patients, particularly those who are not candidates for cystectomy but seek bladder preservation. Ongoing and future trials will be essential to better define the optimal patient populations, refine safety monitoring protocols, and assess whether systemic checkpoint blockade should become a broader part of the non-muscle invasive bladder cancer treatment landscape.