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Published on: January 5, 2017
Circulating Biomarkers in Bladder Cancer
Lakshminarayanan Nandagopal1, Guru Sonpavde1
1Department of Medicine, Section of Hematology-Oncology, University of Alabama at Birmingham (UAB) , Birmingham, AL, USA.
Abstract:
Bladder cancer is a molecularly heterogeneous disease characterized by multiple unmet needs in the realm of diagnosis, clinical staging, monitoring and therapy. There is an urgent need to develop precision medicine for advanced urothelial carcinoma. Given the difficulty of serial analyses of metastatic tumor tissue to identify resistance and new therapeutic targets, development of non-invasive monitoring using circulating molecular biomarkers is critically important. Although the development of circulating biomarkers for the management of bladder cancer is in its infancy and may currently suffer from lower sensitivity of detection, they have inherent advantages owing to non-invasiveness. Additionally, circulating molecular alterations may capture tumor heterogeneity without the sampling bias of tissue biopsy. This review describes the accumulating data to support further development of circulating biomarkers including circulating tumor cells, cell-free circulating tumor (ct)-DNA, RNA, micro-RNA and proteomics to improve the management of bladder cancer.
Insights
Developing non-invasive circulating biomarkers, such as cell-free DNA, is crucial for advancing precision medicine in bladder cancer management. These biomarkers offer a less invasive way to monitor treatment resistance and tumor heterogeneity.
Area of Science:
- Oncology
- Molecular Diagnostics
Background:
- Bladder cancer presents significant challenges in diagnosis, staging, monitoring, and therapy due to its molecular heterogeneity.
- Advanced urothelial carcinoma requires precision medicine approaches, but serial tissue biopsies for monitoring resistance are difficult.
Approach:
- This review focuses on the potential of non-invasive circulating molecular biomarkers for bladder cancer management.
- It examines accumulating data on circulating tumor cells, cell-free circulating tumor DNA (ctDNA), RNA, microRNA, and proteomics.
Key Points:
- Circulating biomarkers offer a non-invasive alternative to tissue biopsies, mitigating sampling bias and capturing tumor heterogeneity.
- While currently in early development with potential sensitivity limitations, these biomarkers are vital for identifying resistance and new therapeutic targets.
- Advancing circulating biomarker analysis is critical for improving bladder cancer patient care.
Conclusions:
- Further development of circulating biomarkers is essential for enhancing the precision medicine paradigm in bladder cancer.
- Non-invasive monitoring through circulating molecular alterations holds promise for overcoming current management limitations.
- This approach could significantly improve diagnosis, staging, and therapeutic strategies for advanced urothelial carcinoma.
