My understanding was they usually want to do BCG treatment more than once to verify it is not working before trying something else. There is a shortage of BCG right now so first priority would go to first timers but if in the trial I would get the BCG for sure and maybe the Keytruda also (trials some get it some do not). Trial closed out week before I could start. So BCG not available for me next options chemo or bladder removal and not ready for that yet even though my cancer is high grade non invasive. High grade comes back quick, have had the cancer scraped out twice now. Came back after first scraping in less than four months. Not sure about Keytruda after chemo but did see some others did get Keytruda after bladder removal and chemo. Keytruda seems to be helping with alot of different cancers. Maybe for us to. Hope the chemo goes well for both of us. Dr said side effects are low and it is well tolerated by most. Take care and keep in touch if you like.