How is NMIBC treated?

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Non-muscle-invasive bladder cancer (NMIBC) treatment is led by an oncologist and a urologist

The NMIBC care team may also include nurses, pathologists, social workers, and nutrition specialists. Treatment depends on the cancer’s stage, and also your and your care team’s goals. Treating NMIBC often includes an intravesical immunotherapy like Bacillus Calmette-Guérin (BCG), which may be used alongside an infusion immunotherapy like IMFINZI. IMFINZI, together with BCG, is a non-surgical treatment option that may help treat high-risk NMIBC that has not previously been treated with BCG.

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Treating NMIBC is a team effort

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A urologist may diagnose your NMIBC and help create your treatment plan. They might perform a procedure called a transurethral resection of the bladder tumor (TURBT). This diagnoses and removes the cancer that can be seen by a doctor.

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An oncologist is a doctor that helps treat all types of cancer. They may recommend medicines like chemotherapy, immunotherapy, or radiation therapy to help treat your NMIBC. Speaking with an oncologist is an important step in your treatment journey.

Who else may be part of your care team?

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Nurse

A healthcare professional who provides care throughout treatment

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Advanced practice provider

A healthcare professional who helps diagnose and treat illnesses. They may be a nurse practitioner or a physician assistant

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Pathologist

A type of doctor who looks at bodies and body tissues to help diagnose illnesses, including cancer

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Social worker

A person who can help people adjust to lifestyle changes due to illness

Treatments that can be given with BCG, like IMFINZI, may help you navigate what's ahead. For questions to help start the conversation, download the doctor discussion guide.

How is high-risk non-muscle-invasive bladder cancer treated?

Treatment for high-risk non-muscle-invasive bladder cancer may depend on several factors. These may include the cancer's stage and risk group, as well as the person's treatment goals. Your doctor may recommend:

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Intravesical immunotherapy:

A treatment given directly into the bladder that helps your immune system find and attack cancer cells in the lining of the bladder.

  • This treatment is given using a catheter, which is a tube that goes through your urethra (the canal that lets urine leave your body). Using a catheter helps deliver the medicine right to your bladder
  • Bacillus Calmette-Guérin (BCG) is an intravesical immunotherapy that is considered the standard treatment for NMIBC
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Infusion immunotherapy:

A treatment given into a vein in your arm that helps your immune system find and attack cancer cells in your body.

  • IMFINZI is an immunotherapy treatment that can be paired with BCG to help treat adults with high-risk NMIBC who have not previously been treated with BCG
  • IMFINZI + BCG is the first and only combination immunotherapy treatment for adults with high-risk NMIBC who have not previously received treatment with BCG

Immunotherapies, including BCG and IMFINZI, may also affect healthy cells.

If your NMIBC is high-risk, talking with your care team about all of your options may help guide you along your treatment journey.

Learn more about how IMFINZI works
Find out more

Helpful highlights: How high-risk NMIBC is treated

Let's review:

  • Depending on the stage and risk group of the cancer, high-risk NMIBC may be treated in different ways
  • IMFINZI and BCG are both immunotherapies
  • BCG is an intravesical therapy that targets cancer cells within the bladder
  • IMFINZI is given with BCG and helps the immune system fight cancer cells. IMFINZI and BCG may also affect healthy cells

Questions to discuss with your care team:

  • What are the treatment options for high-risk NMIBC?
  • How might an infusion immunotherapy help treat my high-risk NMIBC?
  • How might intravesical immunotherapy help treat my high-risk NMIBC?

Important Safety Information

What is the most important information I should know about IMFINZI® (durvalumab)?

IMFINZI is a medicine that may treat certain cancers by working with your immune system. IMFINZI can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen anytime during treatment or even after your treatment has ended.

Call or see your healthcare provider right away if you develop any new or worsening signs or symptoms, including:

What is IMFINZI?

IMFINZI is a prescription medicine used in combination with Bacillus Calmette-Guérin (BCG) to treat a type of bladder cancer called high-risk non-muscle invasive bladder cancer (NMIBC) that has not spread into the muscle layer of the bladder, when you have not had prior treatment with BCG.

It is not known if IMFINZI is safe and effective in children.

 

  • ISI Lungs Problem Symptoms

    Lung problems: cough, shortness of breath, and chest pain

  • ISI Intestinal Problem Symptoms

    Intestinal problems: diarrhea (loose stools) or more frequent bowel movements than usual; stools that are black, tarry, sticky, or have blood or mucus; and severe stomach-area (abdomen) pain or tenderness

  • ISI Liver Problem Symptoms

    Liver problems: yellowing of your skin or the whites of your eyes, severe nausea or vomiting, pain on the right side of your stomach area (abdomen), dark urine (tea colored), and bleeding or bruising more easily than normal

  • ISI Hormonal Gland Symptoms

    Hormone gland problems: headaches that will not go away or unusual headaches; eye sensitivity to light; eye problems; rapid heartbeat; increased sweating; extreme tiredness; weight gain or weight loss; feeling more hungry or thirsty than usual; urinating more often than usual; hair loss; feeling cold; constipation; your voice gets deeper; dizziness or fainting; and changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness

  • ISI Kidney Problem Symptoms

    Kidney problems: decrease in your amount of urine, blood in your urine, swelling of your ankles, and loss of appetite

  • ISI Skin Problem Symptoms

    Skin problems: rash; itching; skin blistering or peeling; painful sores or ulcers in mouth or nose, throat, or genital area; fever or flu-like symptoms; and swollen lymph nodes

  • ISI Pancreas Problem Symptoms

    Pancreas problems: pain in your upper stomach area (abdomen), severe nausea or vomiting, and loss of appetite

  • ISI Other Organ Problem Symptoms

    Problems can also happen in other organs and tissues. These are not all of the signs and symptoms of immune system problems that can happen with IMFINZI. Call or see your healthcare provider right away for any new or worsening signs or symptoms, which may include: Chest pain, irregular heartbeats, shortness of breath or swelling of ankles; confusion, sleepiness, memory problems, changes in mood or behavior, stiff neck, balance problems; tingling, numbness or weakness of the arms or legs; double vision, blurry vision, sensitivity to light, eye pain, changes in eye sight; persistent or severe muscle pain or weakness, muscle cramps, joint pain, joint stiffness or swelling; and low red blood cells and bruising

  • ISI Infusion Reaction Signs and Symptoms

    Infusion reactions that can sometimes be severe or life-threatening. Signs and symptoms of infusion reactions may include: chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, feel like passing out, fever, and back or neck pain

  • ISI Organ or Tissue Transplant Rejection

    Rejection of a transplanted organ or tissue. Your healthcare provider should tell you what signs and symptoms you should report and monitor you depending on the type of organ or tissue transplant that you have had

  • ISI Organ or Tissue Transplant Rejection

    Complications, including graft-versus-host disease (GVHD), in people who have received a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). These complications can be serious and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with IMFINZI. Your healthcare provider will monitor you for these complications

Getting medical treatment right away may help keep these problems from becoming more serious. Your healthcare provider will check you for these problems during your treatment with IMFINZI. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may also need to delay or completely stop treatment with IMFINZI if you have severe side effects

Before you receive IMFINZI, tell your healthcare provider about all of your medical conditions, including if you:

  • have immune system problems such as Crohn's disease, ulcerative colitis, or lupus
  • have received an organ or tissue transplant, including corneal transplant
  • have received or plan to receive a stem cell transplant that uses donor stem cells (allogeneic)
  • have received radiation treatment to your chest area
  • have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome
  • are pregnant or plan to become pregnant. IMFINZI can harm your unborn baby

      Females who are able to become pregnant:

    • Your healthcare provider will give you a pregnancy test before you start treatment with IMFINZI.
    • You should use an effective method of birth control during your treatment and for 3 months after the last dose of IMFINZI.
      Talk to your healthcare provider about birth control methods that you can use during this time.
    • Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with IMFINZI.
  • are breastfeeding or plan to breastfeed. It is not known if IMFINZI passes into your breast milk. Do not breastfeed during treatment and for 3 months after the last dose of IMFINZI.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are the possible side effects of IMFINZI?

IMFINZI can cause serious side effects (see above).

The most common side effects of IMFINZI when used with Bacillus Calmette-Guérin (BCG) in adults with high-risk NMIBC
include increased liver function tests, urinary tract infection, increased level of potassium in blood, pain or discomfort with urination, decreased red blood cells (anemia), blood in urine, increased level of creatinine in the blood, muscle or bone pain, decreased lymphocyte counts, urinate more often, decreased level of sodium in the blood, feeling tired, rash, and fever.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of IMFINZI. Ask your healthcare provider or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects related to AstraZeneca productsReport side effects related to AstraZeneca products. If you prefer to report these to the FDA, either visit www.FDA.gov/medwatch or call 1-800-FDA-1088.

Call your doctor for medical advice about side effects. You may report side effects related to AstraZeneca productsReport side effects related to AstraZeneca products. If you prefer to report these to the FDA, either visit www.FDA.gov/medwatch or call 1-800-FDA-1088.

Please see Full Prescribing Information including Medication Guide for IMFINZI.

What is IMFINZI?

IMFINZI is a prescription medicine used in combination with Bacillus Calmette-Guérin (BCG) to treat a type of bladder cancer called high-risk non-muscle invasive bladder cancer (NMIBC) that has not spread into the muscle layer of the bladder, when you have not had prior treatment with BCG.

It is not known if IMFINZI is safe and effective in children.

Please see Full Prescribing Information including Medication Guide for IMFINZI.

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Important Safety Information

What is the most important information I should know about IMFINZI® (durvalumab)?

IMFINZI is a medicine that may treat certain cancers by working with your immune system. IMFINZI can cause your immune system to attack normal organs and tissues in any area of your body and can

IMFINZI is a medicine that may treat certain cancers by working with your immune system.

Read full Important Safety Information

What is IMFINZI?

IMFINZI is a prescription medicine used in combination with Bacillus Calmette-Guérin (BCG) to treat a type of bladder cancer called high-risk non-muscle invasive bladder cancer (NMIBC) that has not spread into the muscle layer of the bladder, when you have not had prior treatment with BCG.

United States flag iconThis product information is intended for US consumers only.

IMFINZI is a registered trademark and AstraZeneca Access 360 is a trademark of the AstraZeneca group of companies.

©2026 AstraZeneca. All rights reserved. US-105683 Last Updated 5/26