Case 1: Dr. Grivas presented a 49M with T1 high-grade bladder cancer. Panel stressed germline testing, BCG vs IO tradeoffs, shortages, and need for better intravesical trials. Case 2: Dr. Tripathi presented a 54M with variant urothelial cancer; panel favored EV+pembro neoadjuvant, stressed PET/ctDNA monitoring, pathology accuracy, and cystectomy debate. Case 3: Dr. Sonpavde presented a 65M with renal pelvis cancer: panel stressed staging, neoadjuvant chemo+IO, surgery, germline testing, and emerging roles for EV+pembro and utDNA. Case 4: Dr. Bellmunt presented a metastatic UC case: post-chemo, ctDNA− but lung mets found; panel debated adjuvant IO vs observation, noting ctDNA limits and need for better biomarkers.