Editing Non-Muscle Invasive Bladder Cancer (section)

== 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-α'''
*** '''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 IFN‐α 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