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Treatment options after Adstiladrin treatment fails
I was treated with Adstiladrin every 90 days from March 2025, until February 2026, when my doctor found the cancer had returned. Now, after another TURBT and biopsy tomorrow, I will be discussing further treatment options. Has anyone else had Adstiladrin treatments fail? What options were you given, and which did you choose? I'd appreciate any insights.
Background: I was diagnosed with low grade NMIBC in December 2023, underwent TURBT in January 2024, had Mitomycin instilled in the bladder, followed by six BCG treatments. Clear until January 2025, when the doctor found high grade NMIBC carcinoma in situ at a different location on the bladder wall. The cancer was removed and I received Adstiladrin treatments starting in March 2025.
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@djr5, how did your appointment go? What was recommended for your treatment plan?
Hello Colleen,
The urologist and the oncologist recommended Inlexzo. It is a device that is placed in the bladder. It releases gemcitabine at a constant rate, continuously over a period of about three weeks, thereby maintaining the desired level of the drug without variance. After the device has released all of the drug it contains , it is removed and replaced with another. I am going to see Dr. Shah of Mayo Clinic - Rochester on Tuesday for a second opinion. If he is in agreement with the urologist and oncologist, I will start the treatment this month.
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3 Reactions@djr5, how did the appointment go with Dr. Shah? What did you decide?
Hi Colleen,
Dr. Shah was great. He did a cystoscopy, answered my questions effectively, and proposed a rational plan. Because I had one course of six BCG treatments in 2024, but not the second course of six additional treatments (BCG shortage and lack of notice to me by the doctor's office that an additional six were needed), he said that I was ineligible for Inlexzo. I understand "ineligible" to mean that I should have a complete set of 12 BCG treatments before I consider Inlexzo or any alternate treatment, not that am unable to obtain it. I agree. I will have a second TURBT on May 8th and begin the BCG on June 1st. He will do a cystoscopy in the middle of the course of 12 treatments, and another at the end, then determine if, 1) I am NED, 2) I have desease that requires further BCG/treatments, or, 3) if the disease has progressed and a cystectomy is necessary. I will receive the BCG infusions locally in Omaha (likely an infusion center), but Dr. Shah will do the TURBT, cystoscopies, and any surgery that may be necessary. To have someone in the event of a need for quick orders, I will establish a relationship with another urologist locally, if my present urologist is unwill to continue as my urologist, but Dr. Shah will direct my treatment. It feels good to have a solid plan.
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