Early Adoption of ctDNA in Muscle-Invasive Bladder Cancer

This segment explores how circulating tumor DNA (ctDNA) has rapidly become integrated into routine clinical practice for muscle-invasive bladder cancer (MIBC). Panelists discuss early adoption of tumor-informed assays, particularly in the perioperative setting, and how emerging data from trials such as IMvigor010 and IMvigor011 have shaped real-world use. Clinicians highlight that ctDNA is now being utilized across multiple timepoints, including neoadjuvant therapy, post-cystectomy surveillance, and recurrence monitoring. Importantly, ctDNA positivity is increasingly recognized as a stronger predictor of recurrence risk than traditional clinicopathologic features, even in patients with favorable surgical pathology. The discussion underscores a paradigm shift toward molecular residual disease (MRD) assessment as a central component of risk stratification. As adoption grows, ctDNA is redefining how clinicians identify high-risk patients and personalize treatment strategies in bladder cancer care.