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Opinion|Videos|November 18, 2025

Opportunities for Guiding Neoadjuvant Treatment Decisions with ctDNA in MIBC

Author(s)Joshua J. Meeks, MD, PhD, BS, Alan Tan, MD

The panelists propose a nuanced view of molecular testing, suggesting ctDNA's value lies in its positive predictive capacity for identifying advanced disease, while utDNA may offer stronger negative predictive insights.

Episodes in this series

Two experts are featured in this series.

EP. 1 Challenges in MIBC Management and Opportunities for ctDNA-based Testing

EP. 2 Exploratory Analysis of ctDNA in MIBC from CheckMate 274

EP. 2 Exploratory Analysis of ctDNA in MIBC from CheckMate 274

Two experts are featured in this series.

EP. 3 Evaluating ctDNA Biomarkers in MIBC from SunRISe-4

Two experts are featured in this series.

EP. 4 Opportunities for Guiding Neoadjuvant Treatment Decisions with ctDNA in MIBC

The panelists propose a nuanced view of molecular testing, suggesting ctDNA's value lies in its positive predictive capacity for identifying advanced disease, while utDNA may offer stronger negative predictive insights. They explore the challenges of field cancerization in bladder cancer, discussing how different molecular testing platforms might provide complementary information. The experts emphasize the complexity of interpreting molecular markers, highlighting the need for sophisticated, integrated approaches. Their dialogue reveals the evolving landscape of precision medicine, showcasing how multiple testing strategies can offer more comprehensive disease understanding. They critically examine the limitations of current diagnostic methods, discussing how advanced molecular profiling could potentially overcome existing challenges. The discussion emphasizes the importance of developing more refined, patient-specific molecular testing strategies.

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