The link below is to the 2015 Consensus document about BCG and alternatives.
Consensus statement on best practice management regarding the use of intravesical immunotherapy with BCG for bladder cancer
This 10 page document describes the use of treatment of bladder cancer, based on the use of BCG, while also including other treatments that need consideration in the case of BCG failure, relapse, intolerance, or refractory response.
Options for treatment, in the case of BCG failure, and thus candidates in times of unavailability, include intravesical gemcitabine, mitomycin, and docetaxel.
Other options to BCG are discussed.
This is a good starting point to understand SOME of the options to BCG that may be encountered during the shortage.
As always, you and your care team will need to determine the best options for you, whether BCG is or is not available.
Authors, all respected practitioners and frequent authors, include:
Donald Lamm, MD
Southwest Oncology Group; BCG Oncology
Michael O'Donnell MD
University of Iowa
Edward Uchio MD
University of California, Irvine
Ashish Kamat MD & H. Barton Grossman MD
The University of Texas MD Anderson Cancer Center
Link to article:
www.nature.com/articles/nrurol.2015.58