Hello @amu45sin. My husband had postoperative chemo and then BCG, During the BCG maintenance he had the first recurrence so also a BCG failure. His was a highly aggressive UCcarcinoma. He ended up with a radical cystectomy, but there have been new drugs approved for use since his surgery. I would look into their availability as suggested by others. The aggressive nature of your tumor may help to make your treatment decisions. If local medical team does not have access or experience with the newer treatments, it is time for a second opinion at a large cancer referral center. Sometimes it is worth traveling a distance to get your best medical care.