Immunotherapy for High-Risk Non–Muscle-Invasive Bladder Cancer: Is BCG Enough?

Emerging urinary and molecular biomarkers, such as BlaDimiRIO, may help identify patients most likely to benefit from combination therapy. Ongoing BCG-free phase 3 trials (SunRISe-3 and BRIDGE) and multidisciplinary collaboration will shape the next paradigm in NMIBC treatment.

12/24/20251 min read

Intravesical BCG remains the standard for high-risk NMIBC but has relevant limitations, including recurrence, progression, toxicity, and global shortages. Combining BCG with systemic immunotherapy shows modest efficacy gains in some phase 3 trials, but raises concerns about toxicity, cost, and patient selection. Biomarkers may be key to guiding future use.