Alexander Wyatt, PhD, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada, discusses the use of circulating tumor DNA (ctDNA) in the management and risk assessment of muscle invasive bladder cancer. Specifically, Dr Wyatt gives and overview of how ctDNA analysis can allow for the characterization of disease biology on an extremely deep level and lead to molecularly driven trials. This interview took place at the 2020 Genitourinary Cancers Symposium, held in San Francisco, CA.