Advice for Adopting New NMIBC Treatments in the Clinic

In the closing segment, the expert faculty reflect on lessons learned and practical next steps for integrating combination immunotherapy and BCG into the management of high-risk NMIBC. They emphasize that recent phase 3 successes—CREST and POTOMAC—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. Experts stress the value of improving BCG adherence and technique to maximize its efficacy before moving to intensification strategies. They call for continued clinical trial participation, 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.