The emerging clinical landscape of circulating tumor DNA in bladder cancer and renal cell carcinoma from tumor-specific biology to detection strategies and translational hurdles
Narrative review evaluates circulating tumor DNA detection in bladder cancer and renal cell carcinoma, highlighting distinct shedding patterns and key translational hurdles.
Key Points
To review the biological principles, detection strategies, clinical utilities, and translational challenges of circulating tumor DNA in bladder cancer and renal cell carcinoma.
Synthesized biological differences, sample accessibility, and clinical utility of plasma and urine circulating tumor DNA (ctDNA) across stages of bladder cancer and renal cell carcinoma (RCC).
Evaluated analytical platforms, including PCR-based methods and next-generation sequencing, for molecular stratification, minimal residual disease detection, and treatment response monitoring.
Urine ctDNA provides robust signal detection for bladder cancer diagnosis and recurrence tracking because primary lesions shed directly into urine, supporting perioperative risk stratification.
Renal cell carcinoma exhibits low tumor DNA release into circulation, leading to high false-negative rates in localized disease and restricting ctDNA utility primarily to advanced stages.
Key clinical translation barriers include urine preparation complexity, low analytical sensitivity at minimal tumor burdens, interference from clonal hematopoiesis, and cross-platform discrepancies.