"Future trials must be designed to address this limitation because we have learned time and time again that more treatment is too often not better treatment, and it may lead to increased toxic effects and compromise quality of life," Milowsky said.
Looking ahead, Milowsky said the use of predictive biomarkers is expected to further improve bladder cancer care. These biomarkers can help identify patients at high risk of recurrence, allowing doctors to tailor treatments more effectively. One promising tool is circulating tumor DNA, which can help determine which patients will most likely benefit from perioperative therapies.