More options for BCG resistant NMIBC ? From cancercommons.org (2020)
Newly emerging treatment options for NMIBC include:
A new version of BCG, still in development, called VPM1002. Clinical testing suggests it is effective in more than half of patients who have no response to standard BCG.
A gel form of mitomycin, UGN101. The FDA recently granted a priority review designation to this drug for low-grade NMIBC. In a clinical study, 59% of patients with recurrent cancer achieved complete response, and 84% of them have not experienced a recurrence within a year.
A new, viral-based version of interferon (immune cytokine), called nadofaragen firadenovec (Instilidrin). While interferon is not used very much these days, nadofaragen firadenovec produced durable responses in 53% of patients with high-grade NMIBC that did not respond to BCG treatment.
Of course, the biggest news for NMIBC is the recent FDA approval of the immune checkpoint drug pembrolizumab (Keytruda) for systemic (intravenous) treatment of high grade NMIBC that is not responsive to BCG. In clinical testing, 41% of patients experienced complete responses with median duration of 16 months.