Figure 1. Localized or disseminated bladder cancer can be treated with peritumoral or intratumoral injections of CD40 agonistic antibodies. Various immunotherapeutics, including CD40 agonistic antibodies, can be easily administered into neoplastic lesions growing in the bladder urothelium by ultrasound-guided or transurethral injections. CD40 agonistic antibodies can then activate tumor-infiltrating immune cells as well as immune cells in the tumor-draining lymph node. The drainage of these antibodies is paralleled by that of tumor debris, resulting in the efficient priming and/or activation of tumor-specific T cells. These T lymphocyte can home to the tumor and exert antineoplastic effects by multiple mechanisms, including perforin/granzyme-induced apoptosis. Tumor-specific T cells can also control metastatic lesions and prevent disease recurrence.