For early bladder cancer, BCG is the only option, and nothing has improved on it in decades
The core idea stands, but key numbers or details have changed.
TaughtHigh-risk bladder cancer that hasn't invaded the muscle is treated by putting BCG, a tuberculosis vaccine, into the bladder. It has been the standard since the 1970s, and despite the cancer often coming back, nothing has been added to it in a generation.
NowOn 28 May 2026 the FDA approved durvalumab (Imfinzi) in combination with BCG for high-risk, non-muscle-invasive bladder cancer: the first immunotherapy combination for the disease, and the first genuinely new approach layered onto BCG in decades.
What actually happened
BCG works by provoking the immune system inside the bladder, so pairing it with a modern immunotherapy that releases a different brake on immune cells is a natural idea that took a long time to prove. In the POTOMAC trial, adding durvalumab to standard BCG induction and maintenance improved disease-free survival, fewer recurrences over two years, than BCG alone.
The honesty here: BCG itself was never wrong, and remains the backbone; this is an addition, not a replacement, and it comes with the cost and side-effect profile of systemic immunotherapy. That is why it is 'updated.' But the specific thing taught (that early bladder cancer treatment is BCG and only BCG, frozen since the disco era) is no longer the state of the art.
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Who was taught this
Still standard through 2026, so anyone who finished school between 1950 and 2026 learned the earlier version.