Current Status and Future Perspectives of Molecular Residual Disease Testing in Genitourinary Cancers

While the clinical outcome for patients with resectable solid tumors has improved in recent years, the risk of postoperative recurrence underscores the need for effective monitoring in cancer patients. Molecular residual disease (MRD) refers to the presence of microscopic cancer that remains undetectable on conventional imaging or pathology. Because of the rapid advancement in circulating tumor DNA (ctDNA) analysis using next-generation sequencing technology, MRD testing using ctDNA has demonstrated significant potential for predicting recurrence in various types of cancer. Similar data are found in genitourinary (GU) cancer, and pivotal research has gradually shed light on the importance of MRD in predicting tumor recurrence. To address these critical advancements in MRD testing in GU cancers, we conducted a review of the clinical utility of MRD testing for GU cancers. In this review, we provide an overview of the potential utility of ctDNA-based MRD detection for GU cancers and highlight several ongoing clinical trials for the development of MRD-guided treatments with ctDNA. ctDNA-based MRD testing has the potential to personalize cancer precision medicine in GU cancers, guiding adjuvant therapy decisions, improving early detection of recurrence, and refining surveillance.