Intravesical chemotherapy in non-muscle-invasive XXXX .

@entity632 @entity1 @entity137 @entity2700 @entity2735 @entity5 @entity1138 @entity1259 @entity189 @entity1139 @entity150 @entity17930 @entity136
UNASSIGNED: Non-muscle-invasive @entity150 (NMIBC) is characterized by a tendency for recurrence and capacity for progression. Intravesical instillation therapy has been employed in various clinical settings, which are summarized within this review. Several chemotherapeutic agents have shown clinical efficacy in reducing recurrence rates in the post-transurethral resection of @entity150 (TURBT) setting, including @entity1138 ( @entity1139 ), @entity632 , and @entity1259 . Mounting evidence also supports the use of intravesical @entity1139 following nephroureterectomy to reduce later urothelial bladder recurrence. In the adjuvant setting, bacillus Calmette-Gu  rin (BCG) immunotherapy is an established first-line agent in the management of @entity2735 ( @entity2735 ) and high-grade non muscle invasive @entity189 ( @entity189 ). Among high and intermediate-risk @entity1 (based on @entity5 grade, size, and focality) improvements in disease-free intervals have been seen with adjunctive administration of @entity1139 prior to scheduled BCG dosing. Following failure of first-line intravesical therapy, @entity136 and @entity17930 have demonstrated modest activity, though @entity17930 remains the only agent currently Food and Drug Administration (FDA)-approved for the treatment of BCG-refractory @entity2735 . Techniques to optimize intravesical chemotherapy delivery have also been explored including pharmacokinetic methods such as urinary alkalization and @entity2700 . Chemohyperthermia and electromotive instillation have been associated with improved freedom from recurrence intervals but may be associated with increased urinary @entity137 . Improvements in therapeutic selection may be heralded by novel opportunities for genomic profiling and refinements in clinical risk stratification.
