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drugsProductApproved2022🇪🇺

Nadofaragene firadenovec

Nadofaragene firadenovec is the first gene therapy for bladder cancer: a virus that makes bladder cells produce interferon for weeks, given once every three months.

Phase 3 (Boorjian 2021): CR 53% at 3 months in CIS; 46% of responders maintained at 12 months. FDA approval December 2022; commercial launch 2023-24 after manufacturing scale-up. Ferring.

Schematic of the modality · Non-replicating adenoviral gene therapy (intravesical) · not a molecule; see the Intravesical therapy (BCG, chemotherapy, devices, gene and viral therapy) page
Mechanism, step by step
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1.Instilled with Syn3 excipient to enhance transduction

Modality
Non-replicating adenoviral gene therapy (intravesical)
Mechanism
Adenovirus vector delivers the IFN-α2b gene to urothelial cells, which secrete interferon locally.
Brand / code
Adstiladrin
Dosing & schedule
Route
Intravesical
Schedule
75 mL once every 3 months
Medicare
Part B (clinician-administered)

Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Intravesical instillation in the urology clinic, quarterly.

Commercial insurance
covered with prior authorisation

Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments. Plans require BCG-unresponsive NMIBC documented per the label.

20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.

Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.

Not appraisedSearch NICE
Notes
No UK marketing authorisation as of September 2026, so no NICE appraisal. Access only through a clinical trial or a company early access scheme.
NHS England
Not routinely funded

Sources: NICE search: nadofaragene firadenovec. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.

Regulatory

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Approvals

RegionYearIndication
US2022BCG-unresponsive high-risk NMIBC with CIS ± papillary tumours

Safety

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Toxicity profile
Adverse eventAny gradeGrade 3+
Fatigue
24%
Bladder spasm
20%
Micturition urgency
19%
Grade 3+ treatment-related
4%

Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.

Trials

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Recruiting now (live from ClinicalTrials.gov)

Recruiting trials near you · live from ClinicalTrials.gov
Nadofaragene firadenovec
intervention: Nadofaragene firadenovec
Open on ClinicalTrials.gov →

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Latest papers

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Literature trend22 papers in the last 12 months+16% vs prior 12How this is computed
Latest papers · live from Europe PMC
Open in Europe PMC

Query for this drug: (TITLE:"Nadofaragene firadenovec" OR ABSTRACT:"Nadofaragene firadenovec" OR TITLE:"Adstiladrin" OR ABSTRACT:"Adstiladrin") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Nadofaragene firadenovec, not a curated reading list.

Connected

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