Cretostimogene grenadenorepvec produced complete responses in three-quarters of patients with high-risk, BCG-unresponsive non–muscle-invasive bladder cancer with carcinoma in situ in a Phase 3 BOND-003 cohort. Tyson et al reported the results in The Lancet Oncology, describing durability and a safety profile dominated by mild, transient treatment-related adverse events. The international, single-arm trial enrolled 115 patients, with 83 of 110 patients achieving a centrally confirmed complete response at any time after a median follow-up of 25.8 months. The study used intravesical dosing once weekly for six weeks, allowed re-induction for persistent disease, and continued maintenance after complete response. The benchmark jump over the prespecified historical comparator and the fraction maintaining responses at 24 months will be central to how clinicians interpret potential positioning versus existing intravesical and surgical strategies for this difficult-to-treat subgroup.