Pd41-08 Prognostic Value of Circulating Tumor Cells and Cell-Free Dna in Upper Tract Urothelial Carcinoma

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma III (PD41)1 May 2024PD41-08 PROGNOSTIC VALUE OF CIRCULATING TUMOR CELLS AND CELL-FREE DNA IN UPPER TRACT UROTHELIAL CARCINOMA Bernat Padullés, Raquel Carrasco, Fiorella Lizzeth Roldan, Mercedes Ingelmo, Marcel Figueras, Claudia Mercader, Allison Carrascal, Maria Muní, Lourdes Mengual, Laura Izquierdo, and Antonio Alcaraz Bernat PadullésBernat Padullés , Raquel CarrascoRaquel Carrasco , Fiorella Lizzeth RoldanFiorella Lizzeth Roldan , Mercedes IngelmoMercedes Ingelmo , Marcel FiguerasMarcel Figueras , Claudia MercaderClaudia Mercader , Allison CarrascalAllison Carrascal , Maria MuníMaria Muní , Lourdes MengualLourdes Mengual , Laura IzquierdoLaura Izquierdo , and Antonio AlcarazAntonio Alcaraz View All Author Informationhttps://doi.org/10.1097/01.JU.0001008568.76803.f1.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Currently there are no reliable prognostic factors to determine which upper tract urothelial carcinoma (UTUC) patients will progress after radical nephroureterectomy (RNU). The objective of this study was to evaluate whether two different liquid biopsy-based biomarkers circulating tumor cells (CTCs) and cell-free DNA (cfDNA) were able to predict localized UTUC patient's outcome undergoing RNU. METHODS: A total of 20 consecutive localized UTUC patients from two different centers were prospectively included between 2021 and 2023. Two 10 mL EDTA tubes of peripherical blood were collected before treatment (RNU) and 3 months later to isolate CTCs and cfDNA. CTC enumeration and cfDNA levels were evaluated using IsoFlux system and Quant-iT PicoGreen dsDNA kit, respectively. Tumor dissemination was controlled postoperatively via a computed tomography scan periodically. Univariate regression analysis was performed on CTC enumeration and cfDNA level at two different follow-up time points to examine their influence on tumor progression. Kaplan–Meier curves were generated and compared using log-rank tests. RESULTS: Twelve males and 8 females with a median age of 71 years (range 48-90) were analyzed. Ten patients had non-invasive disease (15% pTa and 35% pT1) while the remaining 10 had invasive disease (20% pT2 and 30% pT3). During a median follow-up of 13 months (range 3 to 28), 6 (30%) patients progressed and 3 (15%) died. Univariate analysis demonstrated that both CTC number and cfDNA levels 3 months after RNU are significant predictors of tumor progression (p=0.022 and p=0.029, respectively). Moreover, cfDNA levels at three months after RNU are a significant prognostic biomarker for cancer specific survival (CSS; p=0.016). Kaplan-Meier curves show that both CTC number and cfDNA levels 3 months after RNU can discriminate two groups of patients with significatively different probability of tumor progression. Additionally, cfDNA levels are also able to discriminate patients with different probability of CSS after RNU. CONCLUSIONS: The results of this pilot study show that both CTC enumeration and cfDNA levels 3 months after RNU are prognostic biomarkers in UTUC. Even though these results need further validation in larger and independent series, our results suggest that the evaluation of these liquid-biopsy based biomarkers in routine clinical practice could improve the clinical management of UTUC patients. Source of Funding: Private funding © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e889 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Bernat Padullés More articles by this author Raquel Carrasco More articles by this author Fiorella Lizzeth Roldan More articles by this author Mercedes Ingelmo More articles by this author Marcel Figueras More articles by this author Claudia Mercader More articles by this author Allison Carrascal More articles by this author Maria Muní More articles by this author Lourdes Mengual More articles by this author Laura Izquierdo More articles by this author Antonio Alcaraz More articles by this author Expand All Advertisement PDF downloadLoading ...