Intravesical therapy has been used in the management of superficial transitional 
cell carcinoma (TCC) of the urinary bladder (i.e., Ta, Tl, and carcinoma in 
situ) with specific objectives which include treating existing/residual tumor, 
preventing recurrence of tumor, preventing disease progression, and prolonging 
survival. The initial clinical stage and grade remain the main determinant 
factors in survival irrespective of the treatment. Presently, bacillus 
Calmette-Guerin (BCG) immunotherapy remains the most effective treatment and 
prophylaxis for TCC (Ta, Tl, CIS) and has positive outcomes on tumor recurrence 
rate, disease progression, and prolongation of survival. Prostatic urethral 
mucosal involvement with bladder cancer can be effectively treated with BCG 
intravesical immunotherapy-it has demonstrated a reduction in tumor recurrence 
rates, but has had no positive impact on disease progression or prolongation of 
survival. Interferons, keyhole-limpet hemocyanin (KLH), bropirimine, and 
PHOTOFRIN-photodynamic therapy (PDT) are under investigation in the management 
of TCC and early results are encouraging. This comprehensive review highlights 
recent developments in intravesical therapy of bladder cancer and summarizes the 
mechanisms of action of BCG, and the important role of intravesical BCG 
immunotherapy and other immunotherapeutic agents in the therapy and prophylaxis 
of superficial TCC of the urinary bladder.