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. Dr. Sonpavde provides an update on the latest analysis from the phase 3 global study of EV in combination with pembro. Dr. Sonpavde provides an overview of a phase I/II trial in progress on V940 (mRNA-4157) for resected high-risk MIUC. Drs. Roupret and Houede dissect their research on the safety and efficacy of durvalumab with NAC for operable high-risk UTUC. Preliminary results of the study showed promising efficacy and safety with neoadjuvant treatment with DV plus toripalimab. EV with erdafitinib is a feasible combination with the ability to provide promising antitumor activity in mUC. Dr. Kitamura shares the differences observed between the JAVEMACS and JAVELIN Bladder 100 patient cohorts. Dr. Hassanzadeh elaborates on the benefits of MDT for patients with progressive or de novo disease. Drs. Grivas, Khaki, and Raychaudhuri discuss a phase II trial evaluating pembrolizumab plus aMVAC for non-UC MIBC.