Two studies reinforced circulating tumor DNA’s clinical utility in urothelial cancers. Fox Chase’s RETAIN‑2 phase 2 trial reported that ctDNA can stratify muscle‑invasive bladder cancer patients for bladder‑preserving strategies, identifying those with low metastatic risk who might safely defer cystectomy. Separately, a multicenter study in Nature Communications showed tumor‑informed ctDNA guided FGFR‑targeted therapy decisions in metastatic urothelial cancer, offering a less invasive alternative to tissue profiling. Together these papers indicate ctDNA’s growing role in both surgical decision making and targeted therapy selection, with implications for trial design, regulatory endpoints, and diagnostics reimbursement.