The article by Buisan and colleagues [1], with an accompanying editorial by Meeks [2], addresses priming of the immune system to enhance responses to bacillus Calmette-Guérin (BCG) therapy in non–muscle-invasive bladder cancer (NMIBC). This concept was first suggested in 1987, when patients with a positive purified protein derivative (PPD) tuberculin skin test owing to prior antituberculous vaccine had better outcomes than PPD-negative patients [3]. Furthermore, among patients who had received combined intradermal + intravesical BCG, PPD test conversion from nonreactive to reactive occurred in 61%, compared to 60% of patients who received intravesical BCG alone.
The article by Buisan and colleagues [1], with an accompanying editorial by Meeks [2], addresses priming of the immune system to enhance responses to bacillus Calmette-Guérin (BCG) therapy in non–muscle-invasive bladder cancer (NMIBC). This concept was first suggested in 1987, when patients with a positive purified protein derivative (PPD) tuberculin skin test owing to prior antituberculous vaccine had better outcomes than PPD-negative patients [3]. Furthermore, among patients who had received combined intradermal + intravesical BCG, PPD test conversion from nonreactive to reactive occurred in 61%, compared to 60% of patients who received intravesical BCG alone.