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Non-Muscle Invasive Bladder Cancer
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== Combination intravesical therapy == * '''Combination intravesical chemotherapy''' ** '''No major benefit compared to BCG monotherapy''' * '''BCG combined with intravesical chemotherapy''' ** '''No major benefit compared to BCG monotherapy''' * '''BCG combined with other immunotherapy''' ** '''BCG and interferon-Ξ±''' *** '''Advantages:''' **** '''Some activity in BCG failures, but may not be more effective than BCG alone''' ***** [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464648/ 2017 Cochrane Review] ***** '''Studies: 5 RCTs''' ***** '''Population: 1231 patients with NMIBC''' (Ta and T1 superficial bladder cancer, with or without carcinoma in situ, treated with TUR) ****** Note that these are not BCG failure patients ***** '''Comparison:''' BCG plus IFNβΞ± vs. BCG alone ***** '''Results:''' ****** No difference in risk of recurrence ****** No difference in risk of progression ****** No difference in cancer-specific survival **** '''Favourable side-effect profile''' ***** '''Usually better than BCG alone because most of the side effects are related to the BCG and its dose is reduced in this regimen.''' *** '''Disadvantages''' **** '''More expensive than BCG monotherapy''' ** Ongoing clinical trials are examining different drug combinations as well as surgical techniques, such as chemo-hyperthermia
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