Case-Based Review

Noninvasive Bladder Cancer: Diagnosis and Management


 

References

In patients who have failed BCG treatment and are not surgical candidates or do not desire surgical intervention, intravesical valrubicin is emerging as a treatment alternative. It is currently the only therapy that is approved by the U.S. Food and Drug Administration for treatment of BCG-refractory carcinoma in situ in nonsurgical candidates. Dinney et al examined the efficacy and safety of valrubicin in BCG-refractory carcinoma in situ and found an 18% complete response rate over the 6-month follow-up period, which correlated with the previously reported response rates in phase II/III trials [93]. Other therapies being investigated for BCG failure include thermochemotherapy, photodynamic therapy, as well as combination intravesical chemotherapies [94].

Conclusion

Though much research is under way on the surveillance, diagnosis, and treatment of NMIBC, time-tested modalities remain the mainstay of management. Ongoing studies will improve our understanding of the disease as new information regarding novel ways of delivering intravesical therapeutics, surveillance modalities, and optimal treatment and follow-up strategies becomes available.

Corresponding author: Frank N. Burks, MD, 31157 Woodward Ave., Royal Oak, MI 48073, fburks@urologist.org.

Financial disclosures: None.

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