Nadofaragene firadenovec

Non-muscle invasive bladder cancer (NMIBC) that is unresponsive to Bacillus Calmette-Guérin (BCG) therapy is a type of cancer that is highly difficult to treat. Patients with BCG-unresponsive NMIBC usually undergo radical cystectomy; however, a surgical procedure may not be possible in all patients. For these patients, gene therapies such as nadofaragene firadenovec can be used as an alternative. Nadofaragene firadenovec is a non-replicating adenoviral vector-based gene therapy carrying a copy of a human interferon-alfa 2b (IFNα2b) gene combined with Syn-3, a polyamide surfactant that facilitates gene transfer across the urothelium and enhances viral transduction. The local expression of IFNα2b in the urothelium has pleiotropic anti-tumor effects. Preclinical studies showed that IFNα induced apoptosis in human BCG-unresponsive bladder cancer (BLCA) cells via the induction of autocrine tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) production.