Beyond the BCG Paradox: Biological Rationale and Clinical Evidence for Combining Intravesical BCG with Immune Checkpoint Inhibitors in High-Risk Non-muscle-Invasive Bladder Cancer - PubMed
4 hours ago
- #Immunotherapy
- #Clinical Trials
- #Bladder Cancer
- Intravesical BCG is the standard treatment for high-risk non-muscle-invasive bladder cancer but faces significant recurrence/progression issues, prompting the exploration of combination therapies.
- The combination of intravesical BCG with immune checkpoint inhibitors is supported by a biological rationale where BCG primes immune responses and ICIs counteract immune exhaustion.
- Clinical evidence for BCG plus ICIs in high-risk NMIBC is mixed, with variable early-phase results and recent phase III data showing no clear improvement in oncological outcomes.
- The therapy remains investigational; adoption into routine practice requires mature phase III evidence, validated biomarkers, and proven superiority over existing treatments.
- Future research should focus on identifying patient subgroups that may benefit most and optimizing combination strategies for durable bladder preservation.