Drs. Koshkin and Nizam discuss how a longer treatment-free interval may predict benefit from pembrolizumab rechallenge. Drs. Koshkin and Nizam break down recent research on pembro in patients with la/mUC who responded to first-course pembro. Dr. Koshkin highlights emerging data on Nectin-4–targeted imaging and radiopharmaceuticals in urothelial cancer. Dr. Koshkin shares an overview of FAP-targeted theranostics, including UCSF-led studies showing FAP PET imaging’s ability. Dr. Grivas provides perspective of the long-term outcomes from the JAVELIN Bladder 100 trial as pertaining to older patients. At the time of a pre-specified interim analysis, significant improvements in EFS and OS were seen. Dr. Tyson discusses real-world decision-making around bladder-sparing options for BCG-unresponsive NMIBC. Surgical resection of the primary tumor can provide survival benefits in certain patients with metastatic UTUC. Previous research has shown that BLC can provide improved detection rates, mainly for high-risk disease and invasive tumors. Dr. Plimack details RETAIN, from early findings with neoadjuvant ddMVAC to the evolution of RETAIN-1 and RETAIN-2. The panel elaborates on what excites them most about the future of UC research, highlighting promising advancements. The panel considers the evolving role of ctDNA in guiding adjuvant therapy decisions, highlighting IMvigor011 and MODERN. The panel shares the NIAGARA findings and results from RETAIN-2 on dose-dense MVAC for bladder preservation. The panel covers 2L treatment options for mUC post-EV/pembro, with emphasis on platinum-based chemo and targeted therapy. The panel debates patient selection, alternative regimens, and the balance between escalation and de-escalation strategies. The panel weighs the impact of long-term survival data from the EV-302 trial, with significant improvements in OS. COSMIC-021 began in 2017 to analyze the effects of cabozantinib alone or with atezolizumab for advanced solid tumors. This newly developed assay can assess the genomic profile of ctDNA in patients with advanced UC. Noah Hahn, MD, gives an overview of durvalumab with intravesical gemcitabine and docetaxel for BCG-unresponsive NMIBC. Drs. Tawagi and Armstrong provide detail and discussion on the bladder cancer research from the 2025 ASCO GU meeting.