Distinct longitudinal patterns of urine tumor DNA in patients undergoing surveillance for bladder cancer

Q: What is the main goal of analyzing urine tumor DNA (utDNA) in this study?

To evaluate whether utDNA analysis of urine samples can replace cystoscopy for surveillance of bladder cancer recurrence.

Q: How accurate was utDNA detection for identifying recurrences?

utDNA was detected in 21/23 recurrences, corresponding to 91% sensitivity, including complete detection of T1, T2, and CIS and 83% detection of Ta tumors, with <1% false-negative results.

Q: How could utDNA analysis change surveillance practices for patients?

It showed potential to reduce the number of cystoscopies by 55%, benefiting 79% of patients, and it detected many recurrences earlier than cystoscopy.

Sep 21, 2026

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Investigating urine tumor DNA (utDNA) as a noninvasive alternative to cystoscopy, this longitudinal prospective observational study followed 47 bladder cancer patients for 2 years and analyzed utDNA at each cystoscopy using the BladMetrix DNA methylation biomarker test. utDNA was detected in 21/23 recurrences (91% sensitivity), including 100% of T1, T2, and carcinoma in situ (CIS) cases and 83% of Ta tumors, with <1% false negatives. utDNA analysis could reduce cystoscopies by 55% for 79% of patients and detect 48% of recurrences earlier; post-surgery utDNA patterns suggested minimal residual disease (6%) and field effect (15%).

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Bladder cancer burden and recurrence risk

Limitations of cystoscopy in surveillance

Urine-based biomarkers and current clinical gaps

Distinct longitudinal patterns of urine tumor DNA inpatients undergoing surveillance for bladder cancer Hege Marie Vedeld 1, Heidi Pharo 1 , Anne Klara Sørbø2, Sara Brandt-Winge 1, May-Britt Five 1, Marine Jeanmougin 1, Per Guldberg3,4 , Rolf Wahlqvist2 and Guro Elisabeth Lind 1,5 1 Department of Molecular Oncology, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Norway 2 Department of Urology, Oslo University Hospital, Norway 3 Danish Cancer Society Research Center, Copenhagen, Denmark 4 Department of Cancer and Inﬂammation Research, Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark 5 Department of Biosciences, The Faculty of Mathematics and Natural Sciences, University of Oslo, Norway Keywords biomarker; BladMetrix; DNA methylation;ﬁeld effect; minimal residual disease; recurrence Correspondence G. E. Lind, Department of Molecular Oncology, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Montebello, 0379 Oslo, Norway Tel: +47 22781729 E-mail: [guro.elisabeth.lind@rr-research.no](guro.elisabeth.lind@rr-research.no) Hege Marie Vedeld and Heidi Pharo are shared ﬁrst authors. (Received 6 September 2023, revised 20 February 2024, accepted 14 March 2024, available online 8 May 2024) doi:10 . 1002/1878-0261 .13639 Cystoscopy is the gold standard for surveillance of non-muscle invasive bladder cancer (NMIBC), but the procedure is invasive and has suboptimal accuracy. The aim of this study was to investigate the potential of analyzing urine samples for the presence of urine tumor DNA (utDNA) to replace cystoscopy for surveillance of bladder cancer recurrence. In this longitudinal, prospective, and observational study, 47 patients were followed for recurrence for 2 years, involving analysis of utDNA using the BladMetrix DNA methylation biomarker test at each cystoscopy. In total, utDNA was detected in 21/23 recurrences (91% sensitivity), including 5/5 T1, T2, and carcinoma in situ (CIS) tumors (100%) and 10/12 Ta tumors (83%), with < 1% false-negative test results. Importantly, utDNA analysis showed the potential to reduce the number of cystoscopies by 55%, beneﬁtting 79% of the patients. Eleven of 23 recurrences (48%) were detected earlier with utDNA than with cystoscopy, and distinct patterns of residual utDNA post-surgery indicated minimal residual disease (MRD) or ﬁeld effect in 6% and 15% of the patients, respectively. In conclusion, utDNA analysis shows high sensitivity to detect tumor recurrence, potential to reduce the number of cystoscopies, and promise to guide patientspeciﬁc surveillance regimens. 1. Introduction With ~ 570 000 new cases each year, bladder cancer is the 10th most commonly diagnosed cancer worldwide, and a leading cause of cancer-related mortality, causing more than 200 000 deaths in 2020 [1] . Approximately 75% of the patients present with non-muscle invasive bladder cancer (NMIBC), generally carrying a good prognosis, with a 5-year cancer-speciﬁc survival close to 90%[2] . Despite a favorable prognosis, thereis a risk of recurrence and progression to muscleinvasive bladder cancer (MIBC), where survival drops to 35% [3] . In high-risk patients, the probability of recurrence and progression at 5 years can reach 78% Abbreviations CIS, carcinoma in situ; ddPCR, droplet digital PCR; dMIQE, Minimum Information for Publication of Quantitative Digital PCR Experiments; EAU, European Association of Urology; EMA, European Medicines Agency; FDA, Food and Drug Administration; MIBC, muscle invasive bladder cancer; MRD, minimal residual disease; NBI, narrow-band imaging; NMIBC, non-muscle invasive bladder cancer; PDD, photodynamic diagnosis; STARD, STAndards for the Reporting of Diagnostic accuracy studies; TURB, transurethral resection of the bladder; utDNA, urine tumor DNA. 2684 Molecular Oncology 18 (2024) 2684–2695 ª 2024 The Authors. Molecular Oncology published b

FAQs

What is the main goal of analyzing urine tumor DNA (utDNA) in this study?

To evaluate whether utDNA analysis of urine samples can replace cystoscopy for surveillance of bladder cancer recurrence.

How accurate was utDNA detection for identifying recurrences?

utDNA was detected in 21/23 recurrences, corresponding to 91% sensitivity, including complete detection of T1, T2, and CIS and 83% detection of Ta tumors, with <1% false-negative results.

How could utDNA analysis change surveillance practices for patients?

It showed potential to reduce the number of cystoscopies by 55%, benefiting 79% of patients, and it detected many recurrences earlier than cystoscopy.

Sep 21, 2026

Uploaded by Eden