Improving Patient Communication and Treatment Decisions with ctDNA Monitoring in MIBC

In this segment, panelists discussed how they communicate the role of ctDNA testing with patients following surgery for bladder cancer. Panelists explained the concept of liquid biopsy, differentiating between tumor-informed assays like Signatera—which track tumor-specific genomic alterations—and non–tumor-informed tests. They noted that while ctDNA negativity is reassuring, it does not eliminate relapse risk, as about 12% of ctDNA-negative patients still recur within a year. They also described the potential clinical implications of MTM (molecular tumor marker) levels, which may fluctuate and inform the timing or escalation of adjuvant therapy, such as atezolizumab or EV pembro. The conversation emphasized the need for refined strategies to interpret ctDNA kinetics in managing micrometastatic disease. Panelists concluded by underscoring that the IMvigor-011 trial validates ctDNA as both a prognostic and predictive biomarker, paving the way for broader clinical integration.