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Intravesical Bacillus Calmette-Guérin (BCG) immunotherapy is a cornerstone in the management of non-muscle-invasive bladder cancer (NMIBC). Its antitumor effects are mediated through a complex immune response involving both innate and adaptive immunity. Key mechanisms include activation of CD4+ and CD8+ lymphocytes, natural killer cells, and granulocytes, as well as the upregulation of Toll-like receptors and cytokines such as interleukins and interferon-γ. BCG administration typically follows a six-week induction schedule, with maintenance courses extending up to three years to reduce recurrence and progression. Various strains are available, with similar efficacy. Emerging therapies aim to address BCG resistance with novel agents such as nadofaragene firadenovec and cytokine-based therapies like Nogapendekin Alfa Inbakicept showing promise in BCG-unresponsive disease.

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Intravesical Immunotherapy

  • 章节

  • 发表日期：

    2026年

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  • Alexander Hampson,
  • Henry Lazarowicz

摘要

Intravesical Bacillus Calmette-Guérin (BCG) immunotherapy is a cornerstone in the management of non-muscle-invasive bladder cancer (NMIBC). Its antitumor effects are mediated through a complex immune response involving both innate and adaptive immunity. Key mechanisms include activation of CD4+ and CD8+ lymphocytes, natural killer cells, and granulocytes, as well as the upregulation of Toll-like receptors and cytokines such as interleukins and interferon-γ. BCG administration typically follows a six-week induction schedule, with maintenance courses extending up to three years to reduce recurrence and progression. Various strains are available, with similar efficacy. Emerging therapies aim to address BCG resistance with novel agents such as nadofaragene firadenovec and cytokine-based therapies like Nogapendekin Alfa Inbakicept showing promise in BCG-unresponsive disease.