Advice for Adopting New NMIBC Treatments in the Clinic

In the closing segment, the members of the expert faculty reflect on lessons learned and practical next steps for integrating combination immunotherapy and BCG into the management of high-risk non–muscle invasive bladder cancer (NMIBC). They emphasize that recent phase 3 successes—the CREST and POTOMAC trials—highlight meaningful progress in bladder-sparing treatment, though questions remain about optimal duration, patient selection, and real-world implementation. The panel underscores the importance of infrastructure, multidisciplinary collaboration, and shared decision-making to safely deliver immune checkpoint inhibitors alongside intravesical therapy. The experts stress the value of improving BCG adherence and technique to maximize its efficacy before moving to intensification strategies. They call for continued participation in clinical trials, biomarker research (such as ctDNA and utDNA), and educational initiatives to prepare urologists, oncologists, and advanced practice providers for this evolving therapeutic era. The discussion concludes with a unified message of optimism and teamwork in advancing NMIBC care through evidence-based innovation.