Unmet Needs and the Evolving Role of MRD Monitoring in MIBC

In this segment, panelists explored the persistent unmet needs in muscle-invasive bladder cancer (MIBC) despite recent therapeutic advances. They emphasized that while perioperative regimens like GC-durvalumab and EV Pembro have improved complete response rates and long-term survival, the absolute benefit remains modest, underscoring the need for more precise biomarkers and novel agents to achieve broader cures. They noted that MRD (minimal residual disease) detection via ctDNA represents both a prognostic and potentially predictive tool, but integration with drug-specific biomarkers is crucial. Panelists discussed ctDNA-based treatment response monitoring (TRM) as a transformative approach—enabling real-time tracking of tumor dynamics, early detection of resistance, and adaptive treatment decisions. They highlighted opportunities to refine therapy using molecular profiling (e.g., FGFR, HER2) and adaptive strategies to personalize care. Together, they envisioned ctDNA-guided monitoring as central to the future of MIBC management.