{"entity":{"id":"intravesical-therapy","kind":"term","name":"Intravesical therapy (BCG and bladder instillations)","aka":["intravesical","intravesical BCG","BCG","Bacillus Calmette-Guérin","bladder instillation","instillation","instillations","intravesical chemotherapy","intravesical gemcitabine","intravesical mitomycin","BCG maintenance","BCG shortage","TAR-200","intravesical gene therapy","BCG shortages","bladder instillations"],"tldr":"Putting a drug directly into the bladder through a catheter and leaving it for an hour or two, so it treats the lining without going round the body. BCG, a weakened tuberculosis vaccine, has been the most effective such drug for 45 years.","summary":"A single instillation of mitomycin or gemcitabine after TURBT reduces recurrence of low-risk tumours; six weekly BCG instillations plus maintenance for 1-3 years (SWOG schedule) is standard for intermediate- and high-risk NMIBC and carcinoma in situ, provoking a local immune response. BCG shortages have forced reduced-dose and alternative schedules. For BCG-unresponsive disease, intravesical nadofaragene firadenovec (gene therapy), cretostimogene (oncolytic virus), the TAR-200 gemcitabine-releasing device and systemic pembrolizumab now compete with cystectomy; adding durvalumab to BCG (POTOMAC, 2026) extended disease-free survival in high-risk disease. Chemohyperthermia and electromotive delivery are other enhancements.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/BCG_vaccine#Cancer","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/BCG_vaccine#Cancer"}],"tags":[],"related":["turbt","nmibc-vs-mibc","carcinoma-in-situ","cystectomy"],"cancers":["urothelial"],"sections":["immunotherapy"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Treatment jargon"},"route":"/terms/intravesical-therapy/","neighbours":{"term":[{"id":"carcinoma-in-situ","kind":"term","name":"Carcinoma in situ (CIS)","route":"/terms/carcinoma-in-situ/"},{"id":"nmibc-vs-mibc","kind":"term","name":"Non-muscle-invasive vs muscle-invasive bladder cancer (NMIBC / MIBC)","route":"/terms/nmibc-vs-mibc/"},{"id":"cystectomy","kind":"term","name":"Radical cystectomy","route":"/terms/cystectomy/"},{"id":"turbt","kind":"term","name":"Transurethral resection of bladder tumour (TURBT)","route":"/terms/turbt/"}],"cancer":[{"id":"urothelial","kind":"cancer","name":"Bladder & urothelial cancer","route":"/cancers/urothelial/"}],"section":[{"id":"immunotherapy","kind":"section","name":"Immunotherapy","route":"/fronts/immunotherapy/"}]}}