Clinical Features of Bladder Cancer

Non-muscle-invasive bladder cancer (NMIBC), also known as superficial bladder cancer, is the most common form of bladder cancer, comprising roughly 75% of all newly diagnosed bladder cancer in the USA and includes carcinoma in situ (CIS), Ta and T1 lesions. Together Ta and T1 lesions are termed papillary cancers.

 

Non-muscle-invasive bladder cancer types have a low metastatic potential. They are resected and treated with adjuvant intravesical therapy. Inodiftagene vixteplasmid (BC-819) is an experimental intravesical therapy.

Muscle-invasive bladder cancers that are diagnosed de novo or originate from the progression of NMIBC signify a greater risk of metastatic disease and are treated with complete bladder resection. Prevention of progression is a key goal.

 

Diagnosis and NMIBC treatment
Picture7

  • Diagnosed and treated by cystoscopy
  • Tumors are removed by trans-urethral resection (TUR)
  • Tumors then classified pathologically and treated according to their staging
  • After resection, adjuvant Bacille Calmette Guerin (BCG, attenuated tuberculosis bacteria) given into the bladder
  • Inodiftagene vixteplasmid is being tested in patients for whom BCG fails

Inodiftagene vixteplasmid is designed to be included in early treatment for patients diagnosed with NMIBC. The treatment is being tested in two settings: in patients who have been treated with BCG and for whom a single course of treatment has failed; and in patients who have been treated with BCG and for whom two courses of treatment have failed. Disease in the latter population is termed BCG-unresponsive, and there are no standard approaches to therapy for this group. The intravesical approach is well suited for BC-819 treatment, with instillation into the bladder allowing direct contact of high drug concentration without systemic exposure.