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**Sasanlimab + bacillus calmette-guerin** is an investigational combination therapy for non-muscle invasive bladder cancer (NMIBC), specifically for patients who are BCG-naïve and at high risk. Sasanlimab is a humanized monoclonal antibody (IgG4) targeting the programmed death-1 (PD-1) receptor, functioning as an immune checkpoint inhibitor. The drug blocks PD-1 from interacting with its ligands PD-L1 and PD-L2, lifting immunosuppressive signaling and enabling T cell-mediated anti-tumor activity. Bacillus Calmette-Guérin (BCG) is an established immunotherapy (live-attenuated Mycobacterium bovis) used for induction and maintenance in NMIBC. In the pivotal Phase 3 CREST trial, the sasanlimab + BCG combination significantly improved event-free survival compared to BCG alone, reducing risk of disease recurrence or progression by 32%. Sasanlimab is administered subcutaneously, distinguishing it from other PD-1 inhibitors that are typically intravenous.
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