ArticleClinical cancer research : an official journal of the American Association for Cancer Research2023
Circulating Tumor DNA Analysis in Advanced Urothelial Carcinoma: Insights from Biological Analysis and Extended Clinical Follow-up.
Article in Clinical cancer research : an official journal of the American Association for Cancer Research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07756437 (Internal Validation of Circulating Tumor DNA), which is not on this map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Internal Validation of Circulating Tumor DNA (ctDNA) Sequencing in Muscle-Invasive Bladder Cancer and Upper Tract Urothelial Carcinoma: A Prospective Observational Study
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Liquid biopsy and health-related quality of life in cancers: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Pooled it
- Pembrolizumab for advanced urothelial carcinoma: exploratory ctDNA biomarker analyses of the KEYNOTE-361 phase 3 trial.Nature medicine · 2024Trial
- Clinical indications and implications of metastasis-directed therapy and primary-site treatment in metastatic urothelial carcinoma.International journal of clinical oncology · 2026Review
- Liquid biopsy in bladder cancer: towards precision oncology.Journal of translational medicine · 2026Review
- Integrating clinically actionable biomarkers into bladder cancer care - recommendations from the International Bladder Cancer Group.Nature reviews. Urology · 2026Review
- Circulating tumor DNA (ctDNA)-guided adjuvant therapy for muscle-invasive bladder cancer (MIBC): ready for primetime?Annals of translational medicine · 2026Article
- Review
- Promise without practice - charting the path forward for bladder cancer biomarkers.Nature reviews. Urology · 2026Article
- Advances in the management of localized bladder cancers.Nature reviews. Clinical oncology · 2026Review
- Utility of blue-light cystoscopy and tumor-informed ctDNA for management of recurrent high-risk NMIBC with prostatic urethral involvement: A case report.Urology case reports · 2026Article
- [From nontargeted to precision oncology: predictive biomarkers and targeted therapies in advanced urothelial carcinoma].Urologie (Heidelberg, Germany) · 2026Article
- New opportunities and challenges for nonshedder tumors.Fundamental research · 2026Review
- The evolving role of adjuvant immune checkpoint inhibitors in urothelial carcinoma.Translational andrology and urology · 2026Article
- Field cancerization in urothelial carcinoma: molecular alterations and clinical implications.Journal of Cancer · 2026Review
- Research progress in augmentation strategies for PD-1/PD-L1 inhibitors in bladder cancer: from biological determinants to clinical applications.Frontiers in immunology · 2026Review
- Post-IMvigor011 Era: CtDNA-Guided Postoperative Adjuvant Treatment Stratification in Muscle-Invasive Bladder Cancer.Cancer management and research · 2026Review
- Bladder Cancer Biomarkers: Recent Advances in Early Detection, Treatment Prediction, and Prognosis.Oncology research · 2026Review
- Circulating tumor DNA as a prognostic and monitoring biomarker in urothelial cancers.Frontiers in oncology · 2026Review
- Advancing Bladder Cancer Management: The Role of Neoadjuvant and Adjuvant Therapies and Biomarkers in Muscle Invasive Bladder Cancer.Current treatment options in oncology · 2025Review
- Checkmate 274: expanding treatment options for muscle-invasive bladder cancer.Translational andrology and urology · 2025Article
Corrections and comments
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Authors and funding
17 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeTo investigate whether circulating tumor DNA (ctDNA) assessment in patients with muscle-invasive bladder cancer predicts treatment response and provides early detection of metastatic disease. EXPERIMENTAL
designWe present full follow-up results (median follow-up: 68 months) from a previously described cohort of 68 neoadjuvant chemotherapy (NAC)-treated patients who underwent longitudinal ctDNA testing (712 plasma samples). In addition, we performed ctDNA evaluation of 153 plasma samples collected before and after radical cystectomy (RC) in a separate cohort of 102 NAC-naïve patients (median follow-up: 72 months). Total RNA sequencing of tumors was performed to investigate biological characteristics of ctDNA shedding tumors.
resultsAssessment of ctDNA after RC identified metastatic relapse with a sensitivity of 94% and specificity of 98% using the expanded follow-up data for the NAC-treated patients. ctDNA dynamics during NAC was independently associated with patient outcomes when adjusted for pathologic downstaging (HR = 4.7; P = 0.029). For the NAC-naïve patients, ctDNA was a prognostic predictor before (HR = 3.4; P = 0.0005) and after RC (HR = 17.8; P = 0.0002). No statistically significant difference in recurrence-free survival for patients without detectable ctDNA at diagnosis was observed between the cohorts. Baseline ctDNA positivity was associated with the Basal/Squamous (Ba/Sq) subtype and enrichment of epithelial-to-mesenchymal transition and cell cycle-associated gene sets.
conclusionsctDNA is prognostic in NAC-treated and NAC-naïve patients with more than 5 years follow-up and outperforms pathologic downstaging in predicting treatment efficacy. Patients without detectable ctDNA at diagnosis may benefit significantly less from NAC, but additional studies are needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.