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The ability to identify patients who are least likely to respond to further BCG therapy allows urologists to pursue secondary treatments more likely to convey a recurrence or survival benefit to the patient. We examined the literature to determine what constitutes BCG unresponsive disease. After review, we believe that BCG unresponsive disease should be defined as (1) patients with recurrent high grade T1 disease within 6 months of their primary tumor after at least one course of BCG or patients who have failed at least 2 courses of BCG with either (2) persistent or recurrent pure papillary (Ta) disease within 6 months or (3) persistent or recurrent carcinoma in situ (CIS) within 12 months.<\/jats:p>","DOI":"10.3233\/blc-150015","type":"journal-article","created":{"date-parts":[[2015,10,27]],"date-time":"2015-10-27T16:52:42Z","timestamp":1445964762000},"page":"105-116","source":"Crossref","is-referenced-by-count":17,"title":["Bacillus Calmette-Gu\u00e9rin (BCG) Treatment Failures in Non-Muscle Invasive Bladder Cancer: What Truly Constitutes Unresponsive Disease"],"prefix":"10.1177","volume":"1","author":[{"given":"Ryan L.","family":"Steinberg","sequence":"first","affiliation":[{"name":"University of Iowa Department of Urology, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"University of Iowa Department of Urology, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"University of Iowa Department of Urology, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,10,26]]},"reference":[{"key":"r1","doi-asserted-by":"publisher","DOI":"10.3233\/BLC-159002"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1995.tb07307.x"},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.3.666"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)39546-0"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)42722-4"},{"key":"r6","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)43959-0"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2007.12.011"},{"key":"r8","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)64273-5"},{"key":"r9","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000162059.64886.1c"},{"key":"r10","unstructured":"SiegelRLMillerKDJemalA2015Cancer statistics, CA: A cancer Journal for Clinicians651529"},{"key":"r11","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.09.003"},{"key":"r12","unstructured":"BabjukMBurgerMZigeunerRShariatSFvan RhijnBWComperatE2013EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: Update European Urology644639653"},{"key":"r13","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)53283-8"},{"key":"r14","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410x.2001.02306.x"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)52736-6"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.1016\/1078-1439(95)00041-F"},{"key":"r17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199110243251703"},{"key":"r18","unstructured":"MalmstromPUWijkstromHLundholmCWesterKBuschCNorlenBJ19995-year followup of a randomized prospective study comparing mitomycin C and bacillus Calmette-Guerin in patients with superficial bladder carcinomaSwedish-Norwegian bladder cancer study grouThe Journal of Urology161411241127"},{"key":"r19","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.04.038"},{"key":"r20","doi-asserted-by":"crossref","unstructured":"DuchekMJohanssonRJahnsonSMestadOHellstromPHellstenS2010Bacillus Calmette-Guerin is superior to a combination of epirubicin and interferon-alpha2b in the intravesical treatment of patients with stage T1 urinary bladder cancerA prospective, randomized, Nordic study. 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