Early Detection of Metastatic Progression by Circulating Tumor DNA in Patients Undergoing Bladder-Preserving Trimodality Therapy

PURPOSE: Radical cystectomy and trimodality therapy (TMT) are efficacious treatments for muscle invasive bladder cancer. Novel methods for post-treatment surveillance are needed to detect recurrence. This study assesses the value of plasma circulating tumor DNA (ctDNA) for detection of post-TMT recurrence. MATERIALS AND METHODS: We performed a retrospective ctDNA analysis in 32 patients with at least one post-TMT ctDNA measurement before any disease recurrence. Patients were stratified as post-TMT ctDNA (+) or ctDNA (-) and assessed for metastasis-free survival and recurrence-free survival (RFS) using Kaplan-Meier and Cox regression methods. RESULTS: = .03). CONCLUSIONS: Plasma ctDNA is a potential biomarker for early detection of metastatic progression after TMT. Our hypothesis-generating findings provide a basis for larger studies to evaluate the utility of ctDNA-guided post-TMT surveillance.