Liquid biopsy in genitourinary oncology: From molecular detection to longitudinal precision cancer care

Liquid biopsy is rapidly reshaping precision oncology by enabling minimally invasive and repeatable assessment of tumor-derived molecular signals.Genitourinary (GU) malignancies-including prostate, bladder, and kidney cancers-represent a particularly compelling setting for this approach because both blood and urine can provide clinically relevant and complementary information [1] .Advances in circulating tumor DNA (ctDNA), cell-free DNA (cfDNA), circulating tumor cells, extracellular vesicles, RNA, methylation, and other molecular analytes are extending liquid biopsy beyond genomic profiling toward early detection, risk stratification, treatment selection, response assessment, molecular residual disease (MRD) detection, and recurrence monitoring.In this issue of UroPrecision, two articles illustrate both the breadth and translational potential of the field.Eskandar reviewed the evolving landscape of liquid biopsy across prostate, bladder, and renal cancers, whereas Xu and colleagues reported a multicenter evaluation of an improved urine-based PCA3 assay using microseminoprotein-beta (MSMB) as a reference gene, including the feasibility of non-digital rectal examination urine collection [2,3] .Together, these studies highlighted a broader transition in GU oncology: from static, procedure-dependent assessment toward longitudinal molecular characterization using accessible body fluids.The next phase of the field will require prospective clinical validation, standardized preanalytical and analytical workflows, demonstration of clinical utility, and integration of blood-and urine-based multi-omic measurements with pathology, imaging, and clinical information.