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This combination intravesical chemoimmunotherapy regimen, developed and investigated by Memorial Sloan Kettering Cancer Center, consists of the antimetabolite gemcitabine and the live attenuated bacterial strain bacillus Calmette-Guérin (BCG). The treatment is specifically designed for patients with high-grade non-muscle invasive bladder cancer (NMIBC) that has relapsed after prior BCG therapy. Gemcitabine, a nucleoside analog, functions by inhibiting DNA synthesis and inducing apoptosis in malignant cells. BCG acts as a potent immunotherapy, inducing a local inflammatory response and recruiting immune effector cells, such as T cells and macrophages, to the bladder mucosa to eliminate residual cancer cells. The regimen utilizes an alternating schedule of intravesical administrations to optimize the synergistic effects of chemotherapy-induced tumor cell death and immune-mediated surveillance.
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