Following prostate, lung, and colon cancer, bladder cancer is the fourth most common malignancy in men in the Western world1. Predominantly urothelial carcinomas, more than 70% present as superficial, or non-muscle invasive bladder cancers (NMIBC)2. Bladder cancer is traditionally diagnosed and initially managed with transurethral resection (TUR), which facilitates accurate tumor staging and grading and can provide local disease control. However, NMIBC recurs at rate of 50-80% and has a 14% chance of disease progression following TUR alone. Since the 1970s, perioperative instillation of chemotherapy immediately following TUR has been advocated to destroy residual microscopic tumor cells and to prevent re-implantation. Intravesical therapy has also been employed in an induction and/or maintenance fashion to provide long-term immuno-stimulation of chemotoxicity in an effort to prevent disease recurrence.
