The IMvigor011 trial investigated the efficacy of adjuvant atezolizumab guided by ctDNA testing in patients with invasive bladder cancer after surgery. Patients with positive ctDNA had a 36% lower risk of disease recurrence and a 41% lower risk of death after treatment with atezolizumab compared to placebo. The ctDNA test can identify residual disease after surgery and helps select patients who might benefit from further treatment. Patients with negative ctDNA were untreated and 89% remained disease-free after a mean follow-up of 21.8 months. The study demonstrated that ctDNA can save patients from unnecessary treatment. The results were published in the New England Journal of Medicine. The study was global, randomized and placebo-controlled. No new side effects were reported.