We have had a few posts the last few days about BCG failure and it has made me think of what others have done in that case. Some have reported good results with the use of other agents or addition agents besides BCG. While for others going directly to RC was the best solution. The following may give you information for additional research and give you something to talk to your Urologist about.
This link is from UroToday and is treatment guidelines for blc and what follows are quotes from those guidelines.
Contemporary agent is mitomycin C 40 mg [1mg/ml] given weekly for 6 weeks. Decreases recurrence approximately 17% some effect with CIS. Few systemic side effects due to high molecular weight. Palmar rash and bladder contraction in 1% of patients
Alternate agents include Valrubicin, Classic agent Thiotepa associated with myelosupression due to low molecular weight and systemic absorption.
Subject of several large scale trials.
Combination of BCG with interferon alpha2b suggests additive effect.
Dr. Michael A. O’Donnell is considered to be the go to guy for what to do when there is BCG failure. He had done a great deal of research into alternate intravesical agents. I know that he has done phone consultations with other Urologist for blc patients in the past.