Management of BCG Failures in Superficial Bladder Cancer: A Review

ObjectiveReview management of bacillus Calmette-Guérin (BCG) failures in superficial bladder cancer.MethodSearch of published literature and meeting abstracts.ResultsPatients in whom BCG fails are not a uniform group. Failure cannot be predicted but high-risk patients can be identified. In case of failure and progression the outcome is bad. Conservative but investigative alternatives are BCG/interferon-α, intravesical hyperthermia/chemotherapy, or photodynamic therapy. Standard treatment in failing patients remains cystoprostatectomy.ConclusionBCG failures need careful and individualized therapy in experienced hands.