In the fourth segment of this roundtable series on the muscle invasive bladder cancer landscape, the panel discusses the use of immunotherapy in the adjuvant setting for bladder cancer, focusing on the use of nivolumab based on the results from the CheckMate-274 trial. The panel also discusses the potential synergy of combining enfortumab vedotin with pembrolizumab for patients who relapse after adjuvant immunotherapy, as well as considerations for re-challenging with immunotherapy after adjuvant use.