Table 1.

Intravesical therapies for CIS of the bladder.

Intravesical therapies
Agent	Mechanism of action	Dose
First line
BCG	Stimulates immune response	40–120 mg (depends on strain) [Lamm et al. 2000; Redelman-Sidi et al. 2014]
Second line
Valrubicin	Inhibits nucleic acid synthesis and topoisomerase II	800 mg in 75 ml sterile saline[Dinney et al. 2013b; Greenberg et al. 1997; Steinberg et al. 2000]
MMC	Alkylating agent, inhibits DNA synthesis	40 mg in 20 ml sterile water[Lamm et al. 1995]
BCG + INFα	Stimulates immune response	BCG + 50 million units INFα in 50 ml sterile saline [Luciani et al. 2001; Lam et al. 2003; Punnen et al. 2003]
Gemcitabine	Inhibits nucleic acid synthesis	2000 mg in 50–100 ml sterile saline[Skinner et al. 2013]
Paclitaxel	Inhibits mitosis and induces apoptosis	500 mg in 100 ml sterile saline[Mckiernan et al. 2014]
Docetaxel	Inhibits mitosis and induces apoptosis	75 mg in 100 ml sterile saline[Mckiernan et al. 2006; Barlow et al. 2013]
MCNA	Stimulates immune response	8 mg in 50 ml sterile saline[Morales et al. 2015]
Electromotive MMC	Electric current via catheter enhance membrane permeability	40 mg in 20 ml sterile water[Di Stasi et al. 2003]
Hyperthermic MMC	Local microwave hyperthermia via catheter improves drug penetration	20–40 mg in 50 ml sterile water[Paroni et al. 2001; Van der Heijden et al. 2004]
Gemcitabine + MMC	Inhibits nucleic acid synthesis	1000 mg gemcitabine in 50 ml sterile water; 40 mg MMC in 20 ml sterile water [Cockerill et al. 2015; Lightfoot et al. 2014].

BCG, bacillus Calmette-Guérin; CIS, carcinoma in situ; IFN, interferon, MCNA, Mycobacterium phlei cell wall nucleic acid complex; MMC, mitomycin C.