Inlexzo (gemcitabine intravesical system): promising data but key questions remain.

Journal: World journal of urology

The FDA approval of Inlexzo (gemcitabine intravesical system) marks a significant advance in bladder-sparing treatment for BCG-refractory non-muscle invasive bladder cancer with carcinoma in situ.

The SunRISe-1 trial showed:

  • 82% complete response rate at 3 months
  • More than half of responders maintained their response at 12 months

However, caution is needed due to:

  • The absence of a comparator arm
  • Limited long-term survival data
  • Practical challenges including intravesical delivery, infection risk, and accessibility in resource-limited settings

While Inlexzo offers a promising option where few exist, its definitive role requires:

  • Longer-term follow-up
  • Randomized trials against existing therapies
  • Real-world validation

Clinicians should engage in thorough counseling and shared decision-making with patients before use.

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