What the Literature Says on BCG Refractory Disease and Alternatives

  • Sanchia S. GoonewardeneEmail author
  • Raj Persad
  • Hanif Motiwala
  • David Albala


High-risk non-muscle-invasive bladder cancer (NMIBC) should receive an adjuvant course of intravesical Bacille Calmette-Guerin (BCG) as first-line treatment (Yates and Rouprêt in World J Urol 29(4):415–422, 2011). However, a large amount will have refractory or relapsing disease. Guideline recommendation in the ‘refractory’ setting is radical cystectomy. This chapter covers alternatives to BCG refractory disease in grey literature.


  1. Gontero P, Frea B. Actual experience and future development of gemcitabine in NMI bladder cancer. Ann Oncol. 2006;17(Suppl. 5):v123–8.Google Scholar
  2. Velaer KN, Steinberg RL, Thomas LJ, O’Donnell MA, Nepple KG. Experience with sequential intravesical gemcitabine and docetaxel as salvage therapy for non-muscle invasive bladder cancer. Curr Urol Rep. 2016;17(5):38.Google Scholar
  3. Yates DR, Rouprêt M. Contemporary management of patients with high-risk non-muscle-invasive bladder cancer who fail intravesical BCG therapy. World J Urol. 2011;29(4):415–22.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Sanchia S. Goonewardene
    • 1
    Email author
  • Raj Persad
    • 2
  • Hanif Motiwala
    • 3
  • David Albala
    • 4
  1. 1.East of England DeaneryNorfolk and Norwich University HospitalNorwichUK
  2. 2.North Bristol NHS TrustBristolUK
  3. 3.Southend University HospitalWestcliff-on-SeaUK
  4. 4.Boston UniversityBostonUSA

Personalised recommendations