Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy)
Treating early bladder cancer by putting the drug straight into the bladder through a catheter, so the whole body is spared.
BCG remains the backbone for high-risk NMIBC; intravesical gemcitabine or mitomycin for intermediate risk. The BCG-unresponsive space now has four approved options: pembrolizumab (systemic), nadofaragene firadenovec (2022), N-803 + BCG (2024), and the gemcitabine-eluting TAR-200 device (2025), with cretostimogene filing in 2026. Durvalumab + BCG (2026) is the first systemic immunotherapy added to BCG-naive treatment.
How it works
Direct urothelial exposure to immunostimulants, cytotoxics, viruses, or gene vectors; dwell time and device release kinetics determine efficacy.
- Minimal systemic toxicity
- Bladder preservation
- Repeatable in clinic
- BCG shortages
- Progression to muscle invasion still occurs
- Frequent cystoscopic surveillance
Cretostimogene is a virus engineered to multiply only in bladder cancer cells with a broken RB pathway, instilled into the bladder. It cleared carcinoma in situ in 75% of BCG-unresponsive patients.
A versatile chemotherapy used in pancreatic, bladder, lung, ovarian, breast and biliary cancers, in nasopharyngeal cancer, and as a bladder instillation.
TAR-200 is a small pretzel-shaped device placed in the bladder that releases gemcitabine for three weeks at a time. It was approved in 2025 for early bladder cancer that no longer responds to BCG.
A weakened tuberculosis vaccine put directly into the bladder. Since 1976 it has been the most effective treatment for early bladder cancer, and it remains in chronic short supply.
The chemotherapy given with radiation to cure anal cancer without surgery, used as a bladder instillation after tumour resection, and since 2020-25 in gel form for upper-tract and recurrent bladder cancers.
Nadofaragene firadenovec is the first gene therapy for bladder cancer: a virus that makes bladder cells produce interferon for weeks, given once every three months.
Nogapendekin alfa inbakicept is an engineered version of the immune-boosting protein IL-15, given with BCG into the bladder, approved in 2024 for early bladder cancer that BCG alone no longer controls.
Latest papers
topQuery for this technology: (TITLE:"Intravesical therapy" OR ABSTRACT:"Intravesical therapy" OR TITLE:"BCG, chemotherapy, devices, gene and viral therapy" OR ABSTRACT:"BCG, chemotherapy, devices, gene and viral therapy") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy), not a curated reading list.
Pages like this
not linked directly; found by shared links- TrialQUILT 3.032
Shares Nogapendekin alfa inbakicept, Intravesical BCG, BCG-unresponsive, Bladder & urothelial cancer.
- TrialSunRISe-1
Shares Gemcitabine intravesical system (TAR-200), BCG-unresponsive, Bladder & urothelial cancer.
- TrialBOND-003
Shares Cretostimogene grenadenorepvec, BCG-unresponsive, Bladder & urothelial cancer.
- TrialPOTOMAC
Shares Non-muscle-invasive vs muscle-invasive bladder cancer (NMIBC / MIBC), Intravesical BCG, Bladder & urothelial cancer.
- IdeaOncolytic viruses that make interleukin-12 only inside the tumour
Shares Nadofaragene firadenovec, Cretostimogene grenadenorepvec, Bladder & urothelial cancer.
- CompanyFerring Pharmaceuticals
Shares Nadofaragene firadenovec, Bladder & urothelial cancer.
- TechnologyCystoscopy, blue-light imaging & TURBT
Shares Non-muscle-invasive vs muscle-invasive bladder cancer (NMIBC / MIBC), Bladder & urothelial cancer.
- CompanyCG Oncology
Shares Cretostimogene grenadenorepvec, Bladder & urothelial cancer.