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Sophia Kamran, MD, Massachusetts General Hospital, Boston, MA, discusses bladder-sparing trimodality therapy (TMT) as an effective treatment for muscle-invasive bladder cancer (MIBC). Dr Kamran highlights combining immunotherapy (IO) with TMT, specifically with radiation therapy whereby data has demonstrated synergy which may improve clinical outcomes such as survival data. Multiple trials, including the Phase III SWOG S1806 (NCT03775265) study investigating the addition of atezolizumab to the standard of care (SOC) TMT therapy, will provide an abundance of data to aid in the understanding of how IO will improve upon outcomes for MIBC. Hypofractionated radiation therapy may provide the means to shorten the duration of treatment with radiation, however, early data indicates increased toxicities when combined with IO. Additional information is required to decipher which patients demonstrate these increased toxicities. Adaptive radiation therapy may provide the solution to supplying hypofractioanted radiation therapy in combination with IO. This interview took place at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium 2022 in San Francisco, CA.