Bladder cancer treatment was revolutionized by immunotherapy, but unfortunately, the reality is that many patients are still unresponsive to these treatments. Exciting advances such as genomic treatments like FGFR targeted therapies have provided new strategies for treatment to overcome the drawbacks of current immunotherapy. Randy Sweis, MD, of the University of Chicago Medical Center, Chicago, IL, speaks at the 2019 Genitourinary Cancers Symposium, held in San Francisco, CA, and suggests that a combination of therapies, which takes advantage of multiple approaches, could be the next step in treating patients more effectively. Investigating the unknowns of immunotherapy and uncovering more information about immune responses to the treatment is imperative to designing combination therapies and overcoming resistance in future treatments of bladder cancer.