Amar Kishan, MD gives an overview of the MIRAGE trial that compared MRI-guided and CT-guided SBRT for prostate cancer. In the final segment of a debate series, Brian Rini, MD, and Monty Pal, MD, debate RCC adjuvant therapeutic options. In the second segment of a debate series, Drs. Rini and Pal address kidney cancer clinical trials of interest. In a debate series between Brian Rini, MD, and Monty Pal, MD, they discuss frontline RCC treatment options. Dr. McKay explains how radiation therapy and modalities fit into the treatment paradigm for RCC. Dr. McKay summarizes the novel therapies or optimal sequencing patterns that are close to entering the mRCC treatment space. Dr. McKay offers an overview of the second-line and later-line therapy options after progression for metastatic RCC. Dr. McKay highlights the results of a few studies that support the use of frontline immunotherapy for favorable-risk mRCC. Dr. Rana McKay details how advanced or mRCC is currently managed and how the treatment paradigm has evolved since 2018. Phouc Tran, MD, PhD, highlights the challenges of accurate risk stratification for newly diagnosed localized prostate cancer. Siddharth Ramanathan and Savitha Balaraman, MD, highlight an onsite genetic testing protocol for newly diagnosed with PC. Drs. Howard Korman and Savitha Balaraman describe the importance of genetic testing for patients newly diagnosed with PC. Daniel M. Geynisman, MD, explains the results and utility of the RETAIN trial for bladder sparing in patients with MIBC. Scott Tagawa, MD, MS, FACP, shares what needs to happen for radionuclide therapy to make its way into the community setting. Scott Tagawa, MD, MS, FACP, highlights what clinicians must know prior to recommending Lutetium-177–PSMA-617 to patients. Scott Tagawa, MD, MS, FACP, explains the distinct ways in which PSMA imaging compares to standard cross-sectional imaging. Michael Atkins, MD, discusses TFS outcomes from the phase II study and argues for immunotherapy in favorable-risk patients. Steven Campbell, MD, PhD, overviews the surgical options available for patients with localized renal cell carcinoma. Andrea Necchi, MD, speculates on the applicability of pembrolizumab monotherapy for BCG-unresponsive NMIBC. Chadi Nabhan, MD, MBA, FACP, shares how precision medicine and personalized care have emerged as themes at this Symposium.