Current therapies for BCG-unresponsive NMIBC are not successful in many patients, supporting the need for new bladder-preserving treatments. Two such new intravesical therapies are reviewed in this report: (1) Nadofaragene firadenovec (Adstiladrin®) uses a nonreplicating recombinant adenovirus vector that encodes the human interferon alfa-2b gene with Syn3, a polyamide surfactant, to enhance transfer into cancer cells. It is instilled every three months. In May 2020, the US Food and Drug Administration (FDA) issued a Complete Response Letter requesting additional information regarding manufacturing. (2) Oportuzumab monatox (Vicineium®) is a recombinant fusion protein with a humanized anti-epithelial cell adhesion molecule (EpCAM) single-chain antibody linked to Pseudomonas exotoxin A that binds to the cancer cell and then releases the toxin into the cell, inducing cell death.15 It is instilled twice a week for six weeks, then weekly for six weeks and then every two weeks for up to two years. A rolling Biologics License Application (BLA) was submitted in December 2019.
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