Dr. Steinberg on BCG Progression in Non-Muscle Invasive Bladder Cancer

Gary D. Steinberg, MD, director, Urologic Oncology, The University of Chicago Medicine, discusses bacillus Calmette-Guérin (BCG) progression in non-muscle invasive bladder cancer (NMIBC).

BCG is a form of immunotherapy that is traditionally used in patients with NMIBC. However, one of the problems with high-risk and high-grade NMIBC is that it is not one disease, explains Steinberg, but rather a heterogenous malignancy. There are notable differences in recurrence rates and progression rates that necessitate investigation into whether it is a multifocal tumor, the size, whether or not there is lymphatic or vascular evasion, and the response to intravesical BCG. Additionally, the timing of response to BCG.

There are many factors that physicians have to take into account to help predict which patients are going to progress on BCG. This may be augmented by the identification of biomarkers of response as well as biomarkers of aggressiveness, adds Steinberg.