Circulating Tumor DNA in Muscle-Invasive Bladder Cancer: Implications for Prognosis and Treatment Personalization

Area of Science:

• Oncology
• Molecular Diagnostics
• Genomics

Background:

• Muscle-invasive bladder cancer (MIBC) is aggressive with high recurrence rates.
• Current therapies have limitations in real-time monitoring and personalized treatment adjustments.
• Circulating tumor DNA (ctDNA) presents a novel, non-invasive biomarker for cancer assessment.

Purpose of the Study:

• To review the biological basis, detection methods, and clinical applications of ctDNA in MIBC.
• To highlight ctDNA's role in risk stratification, surveillance, and treatment decisions.
• To discuss emerging uses of ctDNA in precision oncology for MIBC.

Main Methods:

• Review of existing literature on ctDNA in MIBC.
• Analysis of data from pivotal and ongoing clinical trials.
• Examination of ctDNA detection technologies and their clinical utility.

Main Results:

• ctDNA shows promise as a biomarker for assessing tumor burden, treatment response, and minimal residual disease (MRD).
• Evidence supports ctDNA's prognostic and predictive value in MIBC.
• Emerging applications include ctDNA-guided immunotherapy and integration with other diagnostic data.

Conclusions:

• ctDNA can enhance preoperative risk stratification and postoperative surveillance in MIBC.
• It facilitates personalized decision-making for adjuvant and systemic therapies.
• Despite challenges, ctDNA integration into clinical workflows can improve precision oncology and patient outcomes in MIBC.