• Although it is clear that immunocompetent host is mandatory for BCG to exert its action, factors of BCG failure remain largely unknown and unpredictable
• Maintenance BCG is still the most effective intravesical agent, but its role in the progression of papillary tumours needs to be clarified
• BCG remains an alternative to intravesical chemotherapy in intermediate-risk NMIBC, and it is recommended as the standard of care for high-risk NMIBC
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