Implementing ctDNA-Based MRD Testing in MIBC Clinical Practice

In this concluding segment, the panel reflected on practical guidance, patient communication, and the future role of ctDNA testing in bladder cancer. They emphasized that most patients readily accept ctDNA testing, viewing it as empowering information, even when therapeutic decisions remain uncertain. They predicted future studies focused on treatment intensification and de-intensification based on ctDNA status. Panelists cautioned against prematurely adopting bladder-sparing approaches outside of clinical trials, stressing that some patients with apparent complete responses still harbor invasive disease. They discussed the need for more sensitive assays and standardized frameworks for interpreting ctDNA findings. They foresee ctDNA becoming integral to precision oncology, guiding early intervention, escalation, or de-escalation of therapy. Dr. Powles closed by noting that circulating tumor DNA is reshaping bladder cancer care, with the potential to improve cure rates and personalize treatment across disease stages