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Non specific immunotherapy with B.C.G. in superficial bladder cancer: an overview.

In the seventies non specific immunotherapy with B.C.G. was used for a number of malignancies in man. After initial successful reports on leukaemia and melanoma, results could not always be confirmed and the use of B.C.G. seemed to be limited. In 1976 B.C.G. was used for the first time intravesically in patients with superficial bladder cancer. At present non specific immunotherapy with B.C.G. for superficial bladder cancer is considered the most efficacious treatment modality. It is probably the most widely used and most successful immunotherapy in man. A number of issues on this treatment are still unclear. No consensus has been reached about the treatment schedule, optimal dose and appropriate BCG strain while toxicity is more pronounced than in intravesical chemotherapy. Improvement of the treatment as well as basic research are necessary and will determine the exact place of B.C.G. in the coming years.