Treatment of high-risk non-muscle invasive bladder cancer: current status and prospect

Most patients with high-risk non-muscle invasive bladder cancer (NMIBC) undergo transurethral resection of bladder tumor followed by intravesical adjuvant immunotherapy with Bacillus Calmette-Guerin (BCG). But inevitably, some patients can not receive BCG treatment or are doomed to fail BCG-therapy, consequently. So radical cystectomy becomes only treatment option available. In recent years, immunotherapy and targeted therapy have developed rapidly in the field of bladder tumor. In this article, we summarize the current definition, clinical features and treatment of high-risk NMIBC, review the current treatment progress, including the exploration of new therapeutic drugs after BCG treatment failure, and put forward the current challenges in the treatment and propose countermeasures and prospects for the future diagnosis and treatment of high-risk NMIBC.