(UroToday.com) Most patients with newly diagnosed bladder cancer have non-muscle invasive disease (NMIBC). For patients with intermediate or high-risk NMIBC and those with carcinoma in situ (CIS), adjuvant treatment with Bacillus Calmette Guerin (BCG) is recommended by many guideline bodies due to proven benefits in disease recurrence. For patients who become BCG-unresponsive, there have been very limited options for these patients for many years. Radical cystectomy has remained the gold standard through numerous approaches including intravesical and systemic therapies have been investigated. Recently, pembrolizumab has been approved for this indication and, as of a recent publication of phase III data this week, nadofaragene firadenovec, a novel intravesical gene-mediated therapy that delivers the human IFNα2b gene resulting in sustained IFNα2b expression, has proven efficacy. In the primary outcome analysis, 53% of patients with CIS +/- Ta/T1 disease achieved complete response, with 44% of these remaining free of high-grade recurrence at 15 months.