Case 1: Dr. Ghali presented 47M with high-risk Ta bladder cancer; panel debated re-TURBT, IO use, and occupational risks; limited benefit seen with blue light cystoscopy. Case 2: Dr. Sfakianos presented 67M with BCG-unresponsive NMIBC: declined BCG; options include gem/doce, RT, but cystectomy favored; ctDNA+ suggests higher-risk disease. Case 3: Dr. Nyame presented 68M with high-grade bladder cancer, BCG intolerance; concern for understaging; cystectomy favored; ctDNA and imaging guide post-op surveillance. Case 4: Dr. Adesunloye presented a case on metastatic UC with FGFR3 fusion: NGS challenges noted; blood tests useful but miss cases; broader panels and germline testing recommended. Case 5: Dr. Brown presented a case on metastatic UC with HER2+: progression post chemo/IO; options include EV rechallenge, platinum, or T-DXd; dosing and trials key considerations. Case 6: Dr. Reizine presented on a case of micropapillary UC progressed post EV+pembro; ctDNA may predict outcomes; combos and bispecific IO promising; consider re-eval and broader genomic testing.