Circulating Tumour DNA and Its Prognostic Role in Management of Muscle Invasive Bladder Cancer: A Narrative Review of the Literature DOI Creative Commons
Konstantinos Kapriniotis, Lazaros Tzelves, Lazaros Lazarou

et al.

Biomedicines, Journal Year: 2024, Volume and Issue: 12(4), P. 921 - 921

Published: April 21, 2024

Current management of non-metastatic muscle invasive bladder cancer (MIBC) includes radical cystectomy and cisplatin-based neoadjuvant chemotherapy (NAC), offers a 5-year survival rate approximately 50% is associated with significant toxicities. A growing body evidence supports the role liquid biopsies including circulating tumour DNA (ctDNA) as prognostic predictive marker that could stratify patients according to individualised risk progression/recurrence. Detectable ctDNA levels prior have been shown be correlated higher recurrence worse overall prognosis after cystectomy. In addition, status NAC/neoadjuvant immunotherapy pathological response these treatments, persistently detectable being residual at Finally, post-cystectomy disease relapse disease-free (DFS) (OS) might identify population benefit from adjuvant immunotherapy.

Language: Английский

Strategies for Overcoming Immune Evasion in Bladder Cancer DOI Open Access
Juhyun Shin, Jeong Youp Park, Seon Wook Kim

et al.

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(6), P. 3105 - 3105

Published: March 7, 2024

Tumors intricately shape a highly immunosuppressive microenvironment, hampering effective antitumor immune responses through diverse mechanisms. Consequently, achieving optimal efficacy in cancer immunotherapy necessitates the reorganization of tumor microenvironment and restoration responses. Bladder cancer, ranking as second most prevalent malignant urinary tract, presents formidable challenge. Immunotherapeutic interventions including intravesical BCG checkpoint inhibitors such atezolizumab, avelumab, pembrolizumab have been implemented. However, substantial unmet need persists majority bladder patients across all stages do not respond adequately to immunotherapy. establishes that can actively hinder an efficient anti-tumor response. A deeper understanding evasion mechanisms will aid suppressing recurrence identifying viable therapeutic targets. This review seeks elucidate specific explore novel pathways molecular targets might circumvent resistance

Language: Английский

Citations

5
Oncolytic immunotherapy with nivolumab in muscle-invasive bladder cancer: a phase 1b trial DOI
Roger Li, Nancy Villa, Xiaoqing Yu

et al.

Nature Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 9, 2024

Language: Английский

Citations

5
Circulating Tumor DNA in Genitourinary Cancers: Detection, Prognostics, and Therapeutic Implications DOI Open Access
Margo B. Gerke,

Caroline S. Jansen,

Mehmet A. Bilen

et al.

Cancers, Journal Year: 2024, Volume and Issue: 16(12), P. 2280 - 2280

Published: June 20, 2024

CtDNA is emerging as a non-invasive clinical detection method for several cancers, including genitourinary (GU) cancers such prostate cancer, bladder and renal cell carcinoma (RCC). assays have shown promise in early of GU providing prognostic information, assessing real-time treatment response, detecting residual disease relapse. The ease obtaining “liquid biopsy” from blood or urine enhances its potential to be used biomarker. Interrogating these biopsies” ctDNA can then detect common cancer mutations, novel genomic alterations, epigenetic modifications. has undergone investigation numerous trials, which could address needs instance, earlier RCC, therapeutic response prediction castration-resistant monitoring recurrence cancers. utilization liquid biopsy analysis provides promising advancing precision medicine within the field

Language: Английский

Citations

4
High sensitivity ctDNA assays in genitourinary malignancies: current evidence and future directions DOI Creative Commons

Kartik R. Patel,

Soroush Rais–Bahrami, Arnab Basu

et al.

The Oncologist, Journal Year: 2024, Volume and Issue: 29(9), P. 731 - 737

Published: Aug. 2, 2024

In the recent decade, analysis of circulating tumor DNA (ctDNA) has improved cancer care by allowing for rapid detection actionable molecular targets. A new generation tests is now becoming available commercially. These are characterized a superior limit 0.01% vaF or better, radiologically occult residual disease (MRD). MRD have potential to revolutionize neoadjuvant and adjuvant treatment. addition, these can be used as markers assess response. We reviewed current evidence use high-sensitivity assays with particular focus on genitourinary tumors. Multiple studies been reported in urothelial, renal, recently testicular carcinoma. find that sensitivity varies across types setting may reach high 100% urothelial cancer. Specificity tumor-informed appears preserved (98%-100%). Several trials prospectively validating testing biomarker integral studies, mainly

Language: Английский

Citations

4
Circulating tumor DNA: a revolutionary approach for early detection and personalized treatment of bladder cancer DOI Creative Commons
Yan Zhou,

Rongzhong Wang,

Mingtang Zeng

et al.

Frontiers in Pharmacology, Journal Year: 2025, Volume and Issue: 16

Published: March 21, 2025

Bladder cancer is a malignant tumor with high global incidence and recurrence rate. Traditional diagnostic methods, such as cystoscopy urine cytology, have limitations in sensitivity specificity, particularly detecting low-grade bladder cancer. Circulating DNA (ctDNA) offers non-invasive alternative, reflecting genetic characteristics through blood samples. It demonstrates repeatability, making it promising tool for early detection, monitoring, treatment evaluation. Clinical studies shown that ctDNA not only detects burden but also captures dynamic mutations, aiding personalized strategies. Despite its potential, clinical implementation of faces challenges, including optimization detection techniques, standardization, the cost testing. This paper explores role advancing diagnosis treatment, focus on refining application guiding future research toward improved patient outcomes.

Language: Английский

Citations

0
Circulating tumor DNA Clearance as a Predictive Biomarker of Pathologic Complete Response in Patients with Solid Tumors Treated with Neoadjuvant Immune-Checkpoint Inhibitors: a Systematic Review and Meta-Analysis DOI
Carmine Valenza, Erick Figueiredo Saldanha, Yi Gong

et al.

Annals of Oncology, Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

Language: Английский

Citations

0
Prognostic significance of circulating tumor DNA in urothelial carcinoma patients undergoing immune checkpoint inhibitor therapy: a systematic review and meta-analysis DOI Creative Commons

Qingping Ma,

Shufu Hou,

Haibo Ma

et al.

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: April 29, 2025

Background Circulating tumor DNA (ctDNA) has emerged as a novel biomarker with the advantages of being non-invasive and enabling dynamic monitoring, providing significant clinical insights into prognosis management malignancies. However, its prognostic role in patients urothelial carcinoma (UC) receiving immune checkpoint inhibitors (ICI) remains controversial. This study aims to systematically review perform meta-analysis evaluate significance ctDNA levels this specific patient population. Methods We conducted comprehensive search PubMed, Cochrane Library, CNKI, EMBASE databases include studies published up November 14, 2024, assessing value UC treated ICI. Fixed-effects or random-effects models were used association between overall survival (OS), progression-free (PFS)/disease-free (DFS). Funnel plots, Begg’s test, Egger’s test employed assess publication bias. Results Nine from eight articles, comprising total 862 (ICIs), included meta-analysis. Seven investigated baseline circulating status outcomes. Compared without detectable ctDNA, those elevated exhibited significantly shorter survival/disease-free (PFS/DFS) (HR = 2.75, 95% CI 1.36-5.58, P 0.005), though no statistically difference was observed (OS) 2.08, 0.83-5.24, 0.119). Additionally, we evaluated dynamics during ICI therapy. A decline clearance associated improved outcomes (OS: HR 0.10, 0.02-0.47, 0.004; PFS/DFS: 0.27, 0.16-0.45, < 0.001). Conclusions demonstrates that is PFS DFS undergoing Moreover, changes are strongly correlated OS PFS/DFS. Therefore, serves valuable tool for pre-treatment diagnostic assessment stratification plays crucial monitoring treatment response tracking disease progression throughout Systematic registration www.inplasy.com , identifier INPLASY202520058.

Language: Английский

Citations

0
First Results of NURE-Combo: A Phase II Study of Neoadjuvant Nivolumab and Nab-Paclitaxel, Followed by Postsurgical Adjuvant Nivolumab, for Muscle-Invasive Bladder Cancer DOI
Chiara Mercinelli, Marco Moschini, Antonio Cigliola

et al.

Journal of Clinical Oncology, Journal Year: 2024, Volume and Issue: 42(35), P. 4196 - 4205

Published: Sept. 6, 2024

PURPOSE To evaluate the activity and safety of nivolumab with nab-paclitaxel as neoadjuvant therapy, followed by radical cystectomy (RC) postsurgical adjuvant in patients muscle-invasive bladder cancer (MIBC). PATIENTS AND METHODS Eligible had an Eastern Cooperative Oncology Group performance status ≤1 a T2-4aN0-1M0 stage >50% urothelial carcinoma histology were ineligible for or refused cisplatin-based chemotherapy. Patients received four cycles 360 mg once every 3 weeks + 125 mg/m 2 on days 1 8, weeks, RC, then × 13 cycles. The primary end point was pathologic complete response (CR) rate (ypT0N0). Secondary points major (ypT≤1N0), safety, event-free survival (EFS), overall survival. RESULTS Thirty-one enrolled from December 2021 to June 2023; 19 (61.3%) cT2 stage, two (6.5%) N1 16 (51.6%) variant histology. Five (16.1%) less than full courses treatment because treatment-related adverse events (TRAEs). Grade 3/4 TRAEs occurred eight (25.8%). Twenty-eight underwent three RC after evidence clinical CR redo transurethral resection tumor (reTURBT). trial met its point: 10 (32.3%; 95% CI, 16.7 51.4) achieved ypT0N0 response. By including those who reTURBT, 22 (70.9%; 55 87) ypT≤1N0-x After median follow-up 12 months (range, 5-22), disease relapse surgery. 12-month EFS 89.8% (95% 79.5 100). CONCLUSION our knowledge, first results NURE-Combo suggest that this combination could expand therapeutic opportunities immune-chemotherapy MIBC.

Language: Английский

Citations

3
Neo-Adjuvant Therapy for Metastatic Melanoma DOI Creative Commons

Anke M. J. Kuijpers,

Alexander C.J. van Akkooi

Cancers, Journal Year: 2024, Volume and Issue: 16(7), P. 1247 - 1247

Published: March 22, 2024

Melanoma treatment is leading the neo-adjuvant systemic (NAS) therapy field. It hypothesized that having entire tumor in situ, with all of heterogeneous antigens, allows patient’s immune system to have a broader response its shapes and forms. This translates into higher clinical efficacy. Another benefit NAS potentially includes identifying patients who favorable response, which could offer an opportunity for de-escalation extent surgery need adjuvant radiotherapy and/or therapy, as well tailoring follow-up terms frequency visits cross-sectional imaging. In this paper, we will review rationale resectable metastatic melanoma results obtained so far, both immunotherapy BRAF/MEKi discuss assessment interpretation, toxicity surgical considerations. All trials been reported up now investigator-initiated phase I/II either single-agent anti-PD-1, combination anti-CTLA-4 anti-PD-1 or BRAF/MEK inhibition. The good but are especially encouraging immunotherapies, showing high durable recurrence-free survival rates. Combination seems superior, rate pathologic responses, particularly major (MPR = complete [pCR] + near-pCR [max 10% viable cells]) 60% vs. 25–30%. SWOG S1801 trial has recently shown 23% improvement event-free (EFS) after 2 years pembrolizumab when giving 3 doses 15 versus 18 only. community keen see first (expected 2024) NADINA (NCT04949113), randomized between two courses ipilimumab nivolumab, followed by response-driven regimen follow-up. We on eve immunotherapy, becoming novel standard care macroscopic stage III melanoma.

Language: Английский

Citations

2
Prognostic significance of circulating tumor DNA in urothelial carcinoma: a systematic review and meta-analysis DOI Creative Commons

Haoyang Liu,

Junru Chen, Yuchen Huang

et al.

International Journal of Surgery, Journal Year: 2024, Volume and Issue: unknown

Published: April 3, 2024

Circulating tumor DNA (ctDNA) has emerged as a noninvasive technique that provides valuable insights into molecular profiles and disease management. This study aimed to evaluate the prognostic significance of circulating in urothelial carcinoma (UC) through systematic review meta-analysis.

Language: Английский

Citations

2