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From the 19th to the 21st centuries: BCG in the treatment of superficial bladder cancer.

In superficial bladder cancer, bacillus Calmette-Guérin (BCG) is effective in the prevention of tumour recurrences, in the destruction of papillary lesions and, particularly, in the eradication of carcinoma in situ. In comparative trials BCG is superior to chemotherapeutic agents. Recent statistics indicate that though the incidence of bladder cancer continues to increase, the mortality has begun to diminish. The use of BCG has been implicated as an important contributor to this change. The exact mechanisms of action of this anticancer agent remain obscure, but clarification should lead to the development of new, safer and more effective agents. Thus, BCG, an anachronism from the early days of tumour immunology, may lead cancer immunotherapy into the next century.