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The most effective therapeutic option for managing nonmuscle invasive bladder cancer (NMIBC), over the last 30 years, consists
of intravesical instillations with the attenuated strain Bacillus Calmette-Gu´erin (the BCG vaccine). This has been performed as
an adjuvant therapeutic to transurethral resection of bladder tumour (TURBT) and mostly directed towards patients with highgrade
tumours, T1 tumours, and in situ carcinomas. However, from 20% to 40% of the patients do not respond and frequently
present tumour progression. Since BCG effectiveness is unpredictable, it is important to find consistent biomarkers that can aid
either in the prediction of the outcome and/or side effects development. Accordingly, we conducted a systematic critical review to
identify themost preeminent predictive molecular markers associated with BCG response. To the best of our knowledge, this is the
first review exclusively focusing on predictive biomarkers for BCG treatment outcome. Using a specific query, 1324 abstracts were
gathered, then inclusion/exclusion criteria were applied, and finally 87 manuscripts were included. Several molecules, including
CD68 and genetic polymorphisms, have been identified as promising surrogate biomarkers. Combinatory analysis of the candidate predictive markers is a crucial step to create a predictive profile of treatment response.
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Advances in Urology