Intravesical therapy has been used in the management of superficial tr
ansitional cell carcinoma (TCC) of the urinary bladder (i.e., Ta, T1,
and carcinoma in situ) with specific objectives which include treating
existing/residual tumor, preventing recurrence of tumor, preventing d
isease progression, and prolonging survival, The initial clinical stag
e and grade remain the main determinant factors in survival irrespecti
ve of the treatment. Presently bacillus Calmette-Guerin (BCG) immunoth
erapy remains the most effective treatment and prophylaxis for TCC (Ta
, T1, CIS) and has positive outcomes on tumor recurrence rate, disease
progression, and prolongation of survival. Prostatic urethral mucosal
involvement with bladder cancer can be effectively treated with. BCG
intravesical immunotherapy-it has demonstrated a reduction in tumor re
currence rates, but has had no positive impact on disease progression
or prolongation of survival. Interferons, keyhole-limpet hemocyanin (K
LH), bropirimine, and PHOTOFRIN(R)-photodynamic therapy (PDT) are unde
r investigation in the management of TCC and early results are encoura
ging. This comprehensive review highlights recent developments in intr
avesical therapy of bladder cancer and summarizes the mechanisms of ac
tion of BCG, and the important role of intravesical BCG immunotherapy
and other immunotherapeutic agents in the therapy and prophylaxis of s
uperficial TCC-of the urinary bladder. (C) 1997 Wiley-Liss, Inc.