URINE tumour DNA (utDNA) testing recognized sufferers at elevated danger of recurrence following bacillus Calmette-Guérin (BCG) remedy for high-risk non-muscle-invasive bladder most cancers, in keeping with a multicentre examine.
The findings counsel that molecular testing might assist determine recurrence sooner than normal scientific surveillance and probably help extra personalised remedy choices.
Researchers analysed pretreatment and post-treatment urine samples from sufferers present process BCG for non-muscle-invasive bladder most cancers. Samples had been assessed utilizing utDNA testing to categorise molecular illness standing and decide genomic illness burden.
Earlier than the primary BCG remedy, 23 of 57 sufferers (40%) examined constructive for utDNA. Sufferers with constructive outcomes had a 12-month recurrence-free survival of 61%, in contrast with 85% amongst those that examined destructive (hazard ratio: 3.2; p=0.04).
Put up-Remedy Testing Exhibits Stronger Affiliation
The researchers additionally assessed utDNA following BCG remedy. Amongst 43 sufferers who had been clinically destructive for illness after remedy, eight (19%) remained utDNA constructive.
This group had considerably decrease 12-month recurrence-free survival than sufferers who had been utDNA destructive: 25% in contrast with 91% (hazard ratio: 10.0; p<0.001).
These findings point out that molecular proof of residual or recurrent illness could determine sufferers at significantly excessive danger even when scientific surveillance doesn’t but detect recurrence.
Molecular Detection Might Precede Scientific Recurrence
Amongst sufferers who subsequently skilled recurrence, utDNA detected one-third of circumstances whereas scientific surveillance remained destructive. Molecular detection offered a median lead time of 4.1 months earlier than scientific analysis.
Of those lead-time circumstances, 67% subsequently underwent radical cystectomy, whereas 33% progressed to muscle-invasive illness.
The researchers concluded that utDNA testing might present a method of stratifying recurrence danger in sufferers receiving BCG and detecting recurrence at an earlier stage. The findings additionally counsel potential for molecular monitoring to tell choices round remedy intensification or de-escalation.
Additional analysis will probably be wanted to find out how utDNA testing might be integrated into scientific surveillance and whether or not earlier molecular detection can translate into improved outcomes for sufferers with high-risk non-muscle-invasive bladder most cancers.
Reference
Fertitta L et al. Cherry angiomas in people with neurofibromatosis kind 1. JAMA Dermatol. 2026;DOI:10.1001/jamadermatol.2026.2933.
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