Thomas Powles, MBBS, MRCP, MD, from the Barts Cancer Institute, London, UK, discusses how checkpoint inhibitors can be used earlier in bladder cancer at the European Association of Urology (EAU) conference 2017 in London, UK. He explains that the current focus of immune checkpoint inhibitors in bladder cancer is in the advanced or metastatic stage. However, according to Prof. Powles, the bigger picture involves bringing these drugs into earlier disease stages. He speaks about checkpoint inhibitors which are being trialed in an adjuvant setting (CheckMate 274, NCT02632409; IMvigor010, NCT02450331) and neoadjuvant setting (NCT02451423). Prof. Powles concludes that the story of checkpoint inhibitors in bladder cancer has multiple chapters.