Honing the Hunt: A Comprehensive Review of Cell-free Tumor DNA to Predict Neoadjuvant Therapy Efficacy in Bladder Cancer

• Published in: Clinical genitourinary cancer 2024-06, Vol.22 (3), p.102087-102087, Article 102087
• Main Authors: Suartz, Caio V., Martinez, Lucas Motta, Cordeiro, Maurício D., Botelho, Luiz A.A., Gallutti, Fábio P., Mota, José M., Leite, Katia R.M., Toren, Paul, Nahas, William C., Ribeiro-Filho, Leopoldo A.
• Format: Article
• Language: English
• Subjects: Cell-free DNA; Circulating tumor DNA; Radical cystectomy; Systematic review
• ISSN: 1558-7673; 1938-0682
• DOI: 10.1016/j.clgc.2024.102087

To provide an updated view on the role of cell-free DNA as a predictor of pathological response to neoadjuvant therapy in patients with muscle-invasive bladder cancer. A systematic review was conducted from September 2023 to October 2023. Selected studies from the MEDLINE and clinical trial databases were critically analyzed regarding the clinical efficacy of cell-free DNA as a predictive instrument after neoadjuvant therapy in bladder cancer. The methodological quality assessment was based on the QUADAS-2 tool. In this systematic review, we analyzed 5 studies encompassing a cumulative patient cohort of 780 individuals diagnosed with muscle-invasive bladder cancer, with a median follow-up ranging from 6 to 23 months. Among these studies, 4 primarily focused on detecting and analyzing circulating tumor DNA in plasma, while 1 study uniquely utilized cell-free tumor DNA in urine samples. The diagnostic accuracy of cell-free DNA in plasma ranges from 79% to 100%, indicating a variable yet significant predictive capability. In contrast, the study utilizing urinary cell-free DNA demonstrated an accuracy of 81% in predicting treatment response post-neoadjuvant chemotherapy. Cell-free DNA is emerging as a valuable biomarker for predicting response to neoadjuvant chemotherapy in patients with muscle-invasive bladder tumors. This is a systematic review to provide an updated view on the role of cell-free DNA as a predictor of pathological response to neoadjuvant therapy in patients with bladder cancer.