Combination of BCG and interferon intravesical immunotherapy: an update

To provide an update on the use of interferon (IFN) in the treatment of non-muscle invasive bladder cancer (NMIBC). A literature review of intravesical IFN was performed. In vitro evidence suggested that IFN combined with BCG may have a synergistic effect on the immune response, and treatment regimens with IFN have used reduced BCG dosage in an attempt to reduce toxicity. IFN combined with BCG may salvage some patients, single-course BCG failures or late relapsers, while those that relapse quickly may be destined to failure. However, based on the results of a recently reported randomized trial, the addition of IFN may not improve efficacy in BCG na < ve patients. BCG plus IFN remains an alternative in selected patients with NMIBC who fail intravesical BCG.