In the final segment of this roundtable series on muscle invasive bladder cancer, the panel, which consisted of Shilpa Gupta, MD; Kala Sridhar, MD, MSc, FRCPC; Ben Garmezy, MD; and Karine Tawagi, MD, addresses challenges in the second-line metastatic setting, the impact of new agents targeting HER2 and FGFR, and the future of immunotherapy combinations.