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Are aged 18 years or older;\n2. Have a history of pathologically confirmed high-grade Ta or T1 NMIBC without CIS who have completed SOC previously, with recurrent papillary disease seen on cystoscopy, and who are undergoing TURBT without perioperative intravesical chemotherapy;\n3. Are considered high risk for recurrence;\n4. Have Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2;\n5. Have adequate organ and marrow function as defined below:\n\n   * Hemoglobin 9.0 g\u002FdL;\n   * Absolute neutrophil count 1.5 × 109\u002FL (1500 per mm3);\n   * Platelet count 75 × 109\u002FL (75,000 per mm3);\n   * Serum bilirubin 1.5 × institutional upper limit of normal (ULN);\n   * AST (serum glutamic-oxaloacetic transaminase)\u002FALT (serum glutamic-pyruvic transaminase) 2.5 × institutional ULN; and\n   * Creatinine CL 60 mL\u002Fmin by the Cockcroft-Gault formula or by 24-hour urine collection for determination of creatinine CL: Males: Creatinine CL (mL\u002Fmin) = Weight (kg) × (140 - Age)\u002F72 × serum creatinine (mg\u002FdL); or Females: Creatinine CL (mL\u002Fmin) = Weight (kg) × (140 - Age) × 0.85\u002F72 × serum creatinine (mg\u002FdL).\n\nExclusion Criteria:\n\n1. Have a history of CIS or MIBC;\n2. Are receiving any other investigational agents;\n3. Have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to resiquimod (R848), or excipients used in STM-416 including poloxamer 407 and sodium hyaluronate;\n4. Have an uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness\u002Fsocial situations that would limit compliance with study requirements.\n\n   Urinary tract infections are not exclusionary unless they are NCI-CTCAE Grade 3 or higher;\n5. Are a woman of childbearing potential regardless of contraceptive use; Note: Women of childbearing potential are only to be excluded in Phase 1 and Phase 2a to avoid bias due to the low prevalence of NMIBC in this population. 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