Work

Prognostic Utility of ctDNA for Trimodality Therapy Outcomes in Muscle Invasive Bladder Cancer

Year: 2026

Type: article

Abstract: Introduction Trimodality therapy (TMT) for muscle-invasive bladder cancer (MIBC) is a curative option for select patients. There is a lack of predictive factors to identify patients at risk of progression. Our objective is to assess the clinical utility of a ctDNA assay in predicting treatment outcomes following TMT. Patients and Methods A bi-center analysis to identify patients with MIBC (cT2-T4, cN0-N2, cM0-1a) who underwent definitive TMT between 2021-2024 and who had at least one tumor-informed ctDNA measurement obtained during the treatment course was performed. The primary endpoint was disease-free survival (DFS) and analyzed with the Kaplan Meier method. Predictors of disease recurrence were assessed with Cox proportional hazard models. Results Among 39 patients who underwent TMT, the median follow-up was 15.4 months. Among 30 patients with ctDNA measurements pre-TMT, 13 (43.3%) had detectable ctDNA. Persistently detectable ctDNA following TMT suggests worse disease-free survival (N= 3; 7.1 months) compared to patients with persistently undetectable ctDNA (N=15; 17 months) or those with clearance of their ctDNA following TMT (N=9; 26 months) (p=0.07). Conclusions Persistently detectable ctDNA following TMT suggests worse disease-free survival in patients with MIBC. ctDNA after TMT treatment could be utilized for further treatment decisions in the appropriate clinical context.

Source: Clinical Genitourinary Cancer

DOI: 10.1016/j.clgc.2026.102524