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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.
Induction (6 weekly instillations) plus 1-3 years of maintenance reduces recurrence and progression in high-risk NMIBC. Global shortages since 2012 (single US manufacturer, Merck) have forced dose-splitting and priority rules. New combinations: durvalumab + BCG (POTOMAC, approved 2026), N-803 + BCG (Anktiva, 2024), and recombinant BCG (VPM1002) in trials. About 30-40% of patients become BCG-unresponsive.
Attaches to urothelium via fibronectin, is internalised, and triggers a Th1 innate and adaptive immune response with trained immunity.
1.BCG binds fibronectin on disrupted urothelium and is internalised by tumour cells
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance: how tumours escape each drug class · Lines of therapy.
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| Region | Year | Indication |
|---|---|---|
| US | 1990 | Carcinoma in situ of the bladder (TICE BCG) |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Cystitis symptoms | 70% | - |
| Haematuria | 25% | - |
| Fever | 20% | - |
| Systemic BCG infection | 1% | - |
Rare; requires anti-tuberculous therapy. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
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Query for this drug: (TITLE:"Intravesical BCG" OR ABSTRACT:"Intravesical BCG" OR TITLE:"TICE BCG" OR ABSTRACT:"TICE BCG") 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 BCG, not a curated reading list.
Shares BCG-unresponsive, Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy), Bladder & urothelial cancer.
Shares BCG-unresponsive, Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy), Bladder & urothelial cancer.
Shares Non-muscle-invasive vs muscle-invasive bladder cancer (NMIBC / MIBC), Bladder EpiCheck urine methylation test, Bladder & urothelial cancer.
Shares QUILT 3.032, BCG-unresponsive, Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy), Bladder & urothelial cancer.
Shares Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy), Myeloid suppression: TAMs, MDSCs & don't-eat-me signals, Bladder & urothelial cancer.
Shares BCG-unresponsive, Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy), Bladder & urothelial cancer.
Shares BCG-unresponsive, Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy), Bladder & urothelial cancer.
Shares Non-muscle-invasive vs muscle-invasive bladder cancer (NMIBC / MIBC), Bladder & urothelial cancer.