As the molecular knowledge of bladder cancer advanced, an increasing number of new medicines were being tested in clinical trials throughout the range of bladder cancer stages. The emergence of defined disease states that provided more consistent inclusion criteria for the clinical trial design had enhanced clinical trial activity for non-muscle invasive bladder cancer (NMIBC). For a study, researchers examined the current clinical trials landscape in non-muscle invasive bladder cancer in relation to various disease stages.

The majority of ongoing clinical studies were aimed at high-risk NMIBC patients who are either BCG-naive or BCG-unresponsive. Strict criteria for defining the disease state, as well as a clear road to medication approval, promoted clinical trials for patients with BCG-unresponsive NMIBC. Alternative BCG strains, immune-priming with intradermal BCG vaccination, and systemic immune checkpoint blocking were among the most intriguing possible advances for BCG-naive patients. In addition to INSTILADRIN (nadofaragene firadenovec) and targeted medicines such oportuzumab monatox, the latter treatment was being studied in various studies in BCG-unresponsive NMIBC.

After many years of relative stalemate, a slew of novel medicines tested in well-designed clinical trials appeared to be on track for normal clinical application in the near future. These treatments significantly improved the prognosis of patients with NMIBC. The problems of biomarker-driven medication selection, optimum drug sequencing, and rational combination therapy await us.