Topic: Biomarkers

Utilizing ctDNA in Bladder Cancer

Utilizing ctDNA in Bladder Cancer

by | Nov 2024

Leonard G. Gomella, MD, FACS, explores the potential of circulating tumor DNA (ctDNA) and cell-free DNA (cfDNA) as biomarkers in cancer detection, treatment monitoring, and prognosis.

In this 12-minute presentation, Dr. Gomella reviews recent studies, such as those conducted at the European Association of Urology (EAU), demonstrating ctDNA’s potential for early detection, risk assessment, treatment response evaluation, and post-treatment surveillance in bladder cancer. Trials such as InVigor010 highlight ctDNA’s prognostic utility, where analysis revealed that ctDNA positivity predicted a higher risk of relapse.

Gomella reports that innovations extend to ctDNA detection in urine, offering a non-invasive method to monitor disease burden. These developments and the integration of advanced sequencing technologies mark a new era in cancer management, facilitating earlier interventions and more effective treatment planning.

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Imaging and Biomarkers in Patient Selection for Focal Ablation

Imaging and Biomarkers in Patient Selection for Focal Ablation

by | Aug 2024

Ezequiel Becher, MD, discusses the critical role of imaging and biomarkers in selecting patients for focal ablation in prostate cancer treatment.

He highlights the advancements in imaging technologies that have revolutionized prostate cancer diagnostics, particularly multiparametric MRI (mpMRI). In addition to imaging, Dr. Becher underscores the significance of biomarkers in patient selection. While prostate-specific antigen (PSA) levels are traditionally used, they are complemented by more specific biomarkers such as PCA3, TMPRSS2-ERG, and genomic tests that provide a deeper understanding of tumor biology and aggressiveness.

Dr. Becher also addresses the challenges and limitations of current imaging and biomarker techniques. He advocates for continuous refinement of these technologies and the development of standardized protocols to enhance diagnostic accuracy. Looking forward, he points to the potential of artificial intelligence and machine learning in improving diagnostic precision and patient selection processes.

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Diagnosing Renal Masses: Do Advanced Imaging Techniques and Biomarkers Play an Important Role?

Diagnosing Renal Masses: Do Advanced Imaging Techniques and Biomarkers Play an Important Role?

by | Dec 2023

Justin J. Badal, MD, explores how advancements in imaging techniques and biomarkers enhance diagnostic accuracy, inform treatment decisions, and potentially improve patient outcomes. He acknowledges the limitations of traditional imaging modalities, such as ultrasound and computed tomography (CT), and emphasizes the need for more precise tools.
Multiparametric MRI (mpMRI), positron emission tomography (PET) combined with CT or MRI, and the use of biomarkers are all analyzed. These advanced diagnostic tools have the potential to enhance diagnostic accuracy, guide treatment decisions, and ultimately improve patient outcomes. They are a significant step forward in the personalized management of renal cancer.

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Role of Circulating Tumor DNA and Adjuvant Therapy in Urothelial Carcinoma

Role of Circulating Tumor DNA and Adjuvant Therapy in Urothelial Carcinoma

by | Jun 2023

Tyler F. Stewart, MD, discusses the groundbreaking role of circulating tumor DNA (ctDNA) in adjuvant therapy for urothelial carcinoma, highlighting its potential to revolutionize cancer treatment. ctDNA, a fragmented DNA shed by cells into the bloodstream, holds immense promise in identifying minimal residual disease and predicting patient outcomes.

Dr. Stewart emphasizes the significance of ctDNA as a biomarker and its successful application in various cancer types, including colorectal and bladder cancer. He presents studies showcasing the prognostic value of ctDNA monitoring throughout the treatment course, revealing its ability to accurately predict disease recurrence. The assay DNA methodologies, such as digital PCR and targeted capture NGS, offer remarkable sensitivity and customization to individual patients.

Dr. Stewart explores the potential of ctDNA as a predictive marker for perioperative systemic therapy, which could aid in identifying patients who would benefit most from adjuvant therapy. He highlights the positive outcomes observed in ctDNA-positive patients receiving adjuvant atezolizumab, leading to improved disease-free survival and overall survival rates.

Ongoing clinical trials, such as TOMBOLA and ImVigor011, further explore the integration of ctDNA as an essential biomarker in the management of muscle invasive bladder cancer. The extensive research on ultrasensitive ctDNA assays, novel ctDNA assays, and the use of urinary biomarkers for disease monitoring adds to the growing body of evidence supporting the clinical utility of ctDNA in cancer care.

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