Principles of intravesical chemotherapy and immunotherapy.

By tailoring the use and selection of an intravesical agent to the individual patient, it should be possible to reduce toxicity and avoid overtreatment. Similarly, patients with more alarming disease processes can be treated sooner if the need for that more aggressive or toxic therapy is recognized early. Finally, it is important to recognize that patients who fail initial therapy with BCG have a good probability of responding to additional BCG and that there are promising investigational immunotherapies available for those who fail adequate courses of BCG.