Overview Intravesical Recombinant BCG Followed by Perioperative Chemo-immunotherapy for Patients With MIBC Status: Not yet recruiting Trial end date: 2030-06-01 Target enrollment: Participant gender: Summary Current treatment of localized muscle-invasive bladder cancer is still associated with high relapse and death rate as well as the need for complete bladder resection or irradiation. The primary objective of this trial is to increase the rate of pathologic complete remission (pCR) at the time of radical cystectomy by the combination of local bladder instillation with Bacillus Calmette Guérin (BCG) in combination with systemic immunotherapy with atezolizumab and standard chemotherapy with cisplatin/gemcitabine. The trial tests the hypothesis whether BCG can enhance systemic and local immune response and thereby increase pCR rate and consequently also event-free survival. Improving pCR rate would be a next step to the ultimate goal of omitting radical surgery or extensive local radiotherapy to the bladder for these patients. Phase: Phase 2 Details Lead Sponsor: Swiss Group for Clinical Cancer ResearchTreatments: AtezolizumabBCG VaccineGemcitabine