Joaquim Bellmunt, MD, PhD, Beth Israel Deaconess Medical Center, Boston, MA, discusses the results of the Phase III IMvigor010 clinical trial (NCT02450331) evaluating atezolizumab as adjuvant therapy in patients with high-risk muscle invasive bladder cancer (MIBC) after surgical resection. Whilst the overall results of this trial were negative, it was observed that circulating tumor DNA (ctDNA)-positive patients receiving atezolizumab had a survival benefit over ctDNA-negative patients receiving atezolizumab. These results suggest the use of ctDNA as a biomarker to predict response to treatment with atezolizumab, and led to the Phase III IMvigor011 study (NCT04660344), which assesses atezolizumab versus placebo as adjuvant therapy in patients with high-risk muscle-invasive bladder cancer who are ctDNA-positive after a radical cystectomy. This interview took place at the European Society for Medical Oncology (ESMO) 2021 congress.