valrubicin + bacillus calmette-guerin vaccine

This is a **combination therapy consisting of intravesical valrubicin and bacillus Calmette-Guérin (BCG) vaccine**. Valrubicin is a synthetic anthracycline and a topoisomerase II inhibitor with antineoplastic activity; it is used for intravesical therapy of carcinoma in situ (CIS) of the urinary bladder, particularly in cases refractory to BCG therapy[1][7]. Bacillus Calmette-Guérin vaccine is a live-attenuated strain of Mycobacterium bovis and is employed not only as a preventive vaccine against tuberculosis but also as a standard immunotherapy for non-muscle invasive bladder cancer, where it triggers an immune response against cancer cells[2][4]. The combination is relevant for sequential or alternative treatment in BCG-refractory CIS, where valrubicin may be used after BCG failure, although concurrent co-administration as a fixed marketed product is not standard or approved.