BCG in the fight against cancer: exploring its applications in diverse tumour types and future directions
Bacillus Calmette–Guérin (BCG) was repurposed as intravesical immunotherapy for bladder cancer following its success as a tuberculosis vaccine. Its anti-tumour activity is multifaceted. Directly, BCG induces apoptosis, necrosis and oxidative stress through caspase activation, tumour necrosis factor–alpha (TNF-α) signaling and production of nitric oxide and reactive oxygen species (ROS), damaging tumour DNA and proteins [1]. BCG’s preferential cytotoxicity for tumour over normal urothelium appears to reflect selective uptake: malignant urothelial cells commonly activate Rac1/Cdc42-Pak1-dependent macropinocytosis, enabling BCG entry and concentrating downstream cytotoxic and immune effects in tumour cells [2].
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