Integrating ctDNA Into Clinical Decision-Making

In this segment, panelists examine how ctDNA is incorporated alongside traditional clinical, pathologic, and genomic factors in managing MIBC. While biomarkers such as PD-L1 and next-generation sequencing remain part of standard evaluation, ctDNA is increasingly prioritized due to its ability to dynamically assess recurrence risk. Clinicians describe a shift toward broader, often universal testing, given ctDNA’s ability to detect molecular disease even in patients with low-risk pathology. However, the group emphasizes that ctDNA results are not always immediately actionable due to turnaround times and evolving evidence. Instead, ctDNA is frequently used to inform future treatment planning and guide risk discussions with patients. This segment highlights the current transitional phase in GU oncology, where ctDNA is highly informative but not yet fully embedded into standardized treatment algorithms for guiding therapy selection.