Latest Treatment AUA Guideline for NMIBC...Just crossed my screen - October issue of Journal of Urology. Am I reading this correctly!?!?!...See point 26 below....one of two solutions for High Risk NMI bladder cancer patients where cancer persists or is recurrent (after two courses of BCG) and these patients are unwilling or unfit for cystectomy is RECOMMEND ENROLLMET IN A CLINICAL TRIAL. i.e....gamble with an UNPROVEN clinical trial??? So, the FDA turned down MCNA but this is a "formal" RECOMMENDATION??? Source - Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline The Journal of Urology: Oct-2016 (Volume 196, Issue 4) EXCERPT - 26. In a patient with persistent or recurrent intermediate- or high-risk NMIBC who is unwilling or unfit for cystectomy following two courses of BCG, a clinician may recommend clinical trial enrollment. A clinician may offer this patient intravesical chemotherapy when clinical trials are unavailable. (Expert Opinion). https://www.jurology.com/article/S0022-5347(16)30629-2/fulltext?elsca1=etoc&elsca2=email&elsca3=0022-5347_201610_196_4_&elsca4=Urology