Improving Workflow and ctDNA Adoption in MIBC Care

In this segment, panelists discussed the operational and accessibility challenges of implementing Signatera ctDNA testing in clinical practice. They highlighted differences between Europe and the U.S., noting that the assay is widely available in the U.S. for both perioperative and metastatic bladder cancer but remains limited in Europe. He described how tumor-informed ctDNA testing helps monitor patients with complete responses to EV + pembrolizumab, detect emerging mutations (e.g., FGFR or HER2), and guide therapy adjustments dynamically. Expert panelists added that U.S. adoption has improved as Signatera is now integrated into electronic medical records, simplifying test ordering across academic and community settings. They emphasized the need for clear communication with patients about testing goals and results interpretation. While insurance coverage and workflow efficiency have advanced, both experts agreed that further research is needed to define ctDNA’s role in metastatic disease management.