BCG treatment for bladder cancer

The purpose of intravesical instillation is to minimize and delay the recurrence and progression of non-muscle invasive bladder cancer. BCG is currently recognized as the most effective intravesical instillation drug. For high-risk patients, its effect is significantly better than chemotherapy drug instillation and can better prevent recurrence and progression; for medium-risk patients, BCG and chemotherapy drugs are equally effective.

At present, all bladder instillations at home and abroad are live attenuated vaccines. At present, only one domestic company produces BCG vaccine on the market, so there are not many choices. Imported BCG vaccines are still waiting for approval, and there is no obvious difference in the effects of BCG vaccines of different strains.
Bacillus Calmette-Guérin (BCG) is a vaccine developed from attenuated Mycobacterium tuberculosis. It has been widely used in immunization to prevent tuberculosis. Recent studies have found that BCG also has anti-tumor effects, including urothelial carcinoma represented by bladder cancer.
There are currently two explanations for the anti-cancer mechanism of BCG. One is that it inhibits the division and growth of tumor cells by releasing inflammatory cytokines; the other is that it causes the death of tumor cells through certain reactions in the bladder.
Foreign studies have confirmed that intravesical instillation of BCG is an effective intracavitary treatment for superficial bladder tumors and carcinoma in situ. It can reduce the recurrence and progression of bladder tumors after resection and improve the survival rate. Its effect is better than chemotherapy with drugs such as mitomycin and doxorubicin. For high-risk non-muscle-invasive bladder cancer, intravesical instillation of BCG is recommended for immunotherapy.