Recent advances in non-muscle-invasive bladder cancer (NMIBC) offer several innovative therapies, particularly for patients unresponsive to BCG treatment. These options leverage gene therapy, immune stimulation, oncolytic viruses, and novel drug delivery systems to improve outcomes.
Nadofaragene firadenovec is an FDA-approved gene therapy that delivers a modified virus into bladder cells, prompting them to produce interferon alfa-2b. This activates the immune system to target cancer cells. Similarly, Anktiva combined with BCG stimulates NK and T cells to attack tumors. Cretostimogene grenadenorepvec uses a virus to directly kill cancer cells while also enhancing immune responses.
Chemotherapy delivery has been improved with Zusduri, which turns into a gel in the bladder for prolonged contact. Photodynamic therapy uses a light-activated drug to selectively destroy cancer cells with minimal damage to healthy tissue. These therapies expand treatment options beyond traditional surgery or intravesical BCG.