Andrea Apolo, MD, National Cancer Institute, Bethesda, MD, discusses the pilot clinical trial (NCT02788201) of genomics-based therapy assignment with co-expression extrapolation (COXEN) in advanced/metastatic urothelial carcinoma. The study enrolled eight patients who underwent tumor biopsy for COXEN analysis. Although the COXEN personalized medicine method was found to be feasible, it did not demonstrate clinical efficacy in this study. This interview took place during the 2021 Genitourinary Cancers Symposium.