ArticleESMO open2022
Circulating tumour cells to drive the use of neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer.
Article in ESMO open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Tracing the history of clinical practice of liquid biopsy: a bibliometric analysis.Frontiers in immunology · 2025Pooled it
- Liquid biopsy in the clinical management of tumor of urinary system: current status and future developments.Cellular oncology (Dordrecht, Netherlands) · 2026Review
- Liquid biopsy in genitourinary cancers: Diagnostic and prognostic implications.World journal of clinical oncology · 2025Review
- Beyond Visualization: Advanced Imaging, Theragnostics and Biomarker Integration in Urothelial Bladder Cancer.Cancers · 2025Review
- Circulating tumour DNA and circulating tumour cells in bladder cancer - from discovery to clinical implementation.Nature reviews. Urology · 2025Review
- Construction of a column-line graphical model of poor outcome of neoadjuvant regimens for muscle-invasive bladder cancer based on NLR, dNLR and SII indicators.World journal of surgical oncology · 2025Article
- Neoadjuvant treatment patterns and biomarker selection in muscle-invasive bladder cancer.Discover oncology · 2025Review
- Metastasis development in non-muscle-invasive bladder cancer.Nature reviews. Urology · 2025Review
- Liquid biopsy in cancer current: status, challenges and future prospects.Signal transduction and targeted therapy · 2024Review
- Contemporary Molecular Markers for Predicting Systemic Treatment Response in Urothelial Bladder Cancer: A Narrative Review.Cancers · 2024Review
- Network approach in liquidomics landscape.Journal of experimental & clinical cancer research : CR · 2023Review
- Blood-based liquid biopsy: insights into early detection, prediction, and treatment monitoring of bladder cancer.Cellular & molecular biology letters · 2023Review
- Optimization of Preoperative Lymph Node Staging in Patients with Muscle-Invasive Bladder Cancer Using Radiomics on Computed Tomography.Journal of personalized medicine · 2022Article
Corrections and comments
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGuidelines recommend neoadjuvant chemotherapy (NAC) for the treatment of nonmetastatic muscle-invasive bladder cancer (MIBC). NAC is, however, underutilized in practice because of its associated limited overall survival (OS) benefit and significant treatment-related toxicity. We hypothesized that the absence of circulating tumour cells (CTCs) identifies MIBC patients with such a favourable prognosis that NAC may be withheld. PATIENTS AND
methodsThe CirGuidance study was an open-label, multicentre trial that included patients with clinical stage T2-T4aN0-N1M0 MIBC, scheduled for radical cystectomy. CTC-negative patients (no CTCs detectable using the CELLSEARCH system) underwent radical surgery without NAC; CTC-positive patients (≥1 detectable CTCs) were advised to receive NAC, followed by radical surgery. The primary endpoint was the 2-year OS in the CTC-negative group with a prespecified criterion for trial success of ≥75% (95% confidence interval (CI) ±5%).
resultsA total of 273 patients were enrolled. Median age was 69 years; median follow-up was 36 months. The primary endpoint of 2-year OS in the CTC-negative group was 69.5% (N = 203; 95% CI 62.6%-75.5%). Two-year OS was 58.2% in the CTC-positive group (N = 70; 95% CI 45.5%-68.9%). CTC-positive patients had a higher rate of cancer-related mortality [hazard ratio (HR) 1.61, 95% CI 1.05-2.45, P = 0.03] and disease relapse (HR 1.87, 95% CI 1.28-2.73, P = 0.001) than CTC-negative patients. Explorative analyses suggested that CTC-positive patients who had received NAC (n = 22) survived longer than CTC-positive patients who had not (n = 48).
conclusionThe absence of CTCs in MIBC patients was associated with improved cancer-related mortality and a lower risk of disease relapse after cystectomy; however, their absence alone does not justify to withhold NAC. Exploratory analyses suggested that CTC-positive MIBC patients might derive more benefit from NAC.
trial registrationNetherlands Trial Register NL3954; https://www.trialregister.nl/trial/3954.
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