POL Scientific / Bladder / Volume 12 / Issue 2 / DOI: 10.14440/bladder.2024.0072
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MINI-REVIEW

Advances in recombinant Bacillus Calmette–Guérin therapy for bladder cancer from 2015 to 2024: Innovations and challenges

Hanzhao Zhu1,2 ,  Jiani Li1,2 ,  Xintong Zhou1 ,  Kaixia Mi1,2*
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1 Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
2 Medical School, University of Chinese Academy of Sciences, Beijing 101408, China
Bladder 2025 , 12(2), e21200047; https://doi.org/10.14440/bladder.2024.0072
Submitted: 2 December 2024 | Revised: 21 February 2025 | Accepted: 14 April 2025 | Published: 20 May 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: Non-muscle invasive bladder cancer is commonly treated by Bacillus Calmette–Guérin (BCG) therapy, but its efficacy is limited. Research into recombinant BCG (rBCG) aims to enhance its effectiveness and minimize side effects through genetic modifications. Objective: This review explored advancements in rBCG therapy (2015 – 2024), focusing on genetic modifications designed to enhance cytokine production, introduce bacterial effectors, and boost immune responses. It also discusses future research on alternatives such as Mycobacterium smegmatis for safety concerns and integrating rBCG with other therapies to improve patient outcomes. Conclusion: While rBCG therapies offer promising potential, overcoming translational challenges entails interdisciplinary endeavor to address the issues of safety, cost, and accessibility, and ultimately maximize their benefits for bladder cancer patients.

Keywords
Bacillus Calmette–Guérin
Bladder cancer
Immune therapy
Recombinant Bacillus Calmette–Guérin
Funding
This study was supported by the National Key Research and Development Program of China (2022YFC2303200 to KM), the National Natural Science Foundation of China (32170181 and 82361138564 to KM), and the International Joint Research Project of the Institute of Medical Science, University of Tokyo, Japan (Extension-2019- K3006 to KM).
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Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflicts of interest.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific
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