Anktiva, a prescription-only, laboratory-made immune signaling protein, is delivered into the bladder with the long-standing tuberculosis-derived bladder treatment, for early bladder cancer that returned despite it. It often clears flat surface bladder cancer and may help keep the bladder, with mostly local, short-lived side effects, though postponing surgery lets some cancers invade deeper. Evidence comes mostly from manufacturer-run studies without comparison groups, so the true size of benefit remains uncertain. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Urine cytology | Negative | Detects residual high-grade cancer cells |
| Cystoscopy with biopsy | No visible tumor; biopsies free of carcinoma in situ (flat surface cancer) | Defines complete response |
| Serum creatinine / eGFR | Stable within 10% of personal baseline; eGFR above 60 mL/min/1.73 m² | Tracks the frequent creatinine rise |
| Serum potassium | 4.0–4.5 mmol/L | Detects potassium rise |
| Absolute lymphocyte count (ALC) | 1.5–3.5 × 10³/µL | Immune capacity; eligibility and proposed response marker |
| Urinalysis and urine culture | Nitrite and leukocyte esterase (white-cell enzyme) negative; culture no growth | Rules out urinary tract infection before instillation |
| Upper-tract imaging (computed tomography urography) | No filling defects (gaps in the contrast outline) or masses | Detects cancer outside the bladder |
| Pregnancy test (hCG) | Negative | Prevents fetal exposure |
Cadence: Urinalysis before every instillation; cystoscopy and urine cytology every 3 months for 2 years, then every 6 months to year 5, then yearly; mandatory bladder biopsies within the first 6 months; creatinine and potassium before each induction and maintenance course; upper-tract imaging every 1–2 years