Oncotice (Bacillus Calmette-Guérin (Bcg), Tice)

Oncotice is a live attenuated bacterial vaccine used in the management of bladder cancer, acting on the urothelial lining to stimulate an immune response.

• Non‑muscle‑invasive bladder cancer (NMIBC): Reduces recurrence and progression after transurethral resection.
• Carcinoma in situ of the bladder: Provides local immunotherapy to eradicate tumor cells.
• High‑risk NMIBC: Used as maintenance therapy to prolong disease‑free intervals.

• Oncotice contains live attenuated Mycobacterium bovis (BCG) that, when instilled into the bladder, is internalised by urothelial and antigen‑presenting cells. This triggers a Th1‑dominant immune response, releasing cytokines such as IFN‑γ, TNF‑α and interleukins that recruit macrophages and cytotoxic lymphocytes to destroy residual tumor cells and establish immunological memory.

Oncotice may cause a range of adverse reactions, most of which are local to the bladder and some systemic.

Common Side Effects

• Cystitis‑like symptoms: dysuria, urgency, frequency.
• Hematuria: mild to moderate blood in urine.
• Low‑grade fever and chills.
• Fatigue or malaise.
• Mild abdominal discomfort.

Serious or Rare Side Effects

• Systemic BCG infection (disseminated mycobacterial disease).
• Severe allergic reactions including anaphylaxis.
• Persistent high‑grade fever.
• Sepsis or septic shock.
• Acute renal impairment.
• Life‑threatening pneumonitis.

Before using Oncotice, clinicians should assess patient suitability and monitor for adverse events.

• Contraindication: Active tuberculosis or untreated Mycobacterium infection.
• Caution: Immunocompromised patients may have increased infection risk.
• Monitor: Renal function should be evaluated before and during therapy.
• Avoid: Recent urinary tract instrumentation or surgery may increase complications.
• Pregnancy: Use only if clearly needed; potential fetal risk is unknown.
• Store at 2‑8°C: keep refrigerated, protect from light, do not freeze or shake.

Oncotice can interact with other agents that modify immune function or cause overlapping toxicity.

Major Interactions (Avoid)

• Live attenuated vaccines: concurrent administration may increase risk of infection.
• Systemic immunosuppressants (e.g., high‑dose steroids, biologics): may reduce BCG efficacy.

Moderate Interactions (Monitor Closely)

• Antifungal azoles (e.g., fluconazole): may alter BCG metabolism.
• Chemotherapy agents given concurrently: increased bladder toxicity.
• Anticoagulants: heightened risk of hematuria.
• NSAIDs: may exacerbate renal side effects.
• Cytokine‑targeting therapies: potential additive immune effects.