Pd38-01 Negative Ctdna Status Prior to Radical Cystectomy Predicts Improved Outcomes

You have accessJournal of UrologyBladder Cancer: Invasive IV (PD38)1 May 2024PD38-01 NEGATIVE CTDNA STATUS PRIOR TO RADICAL CYSTECTOMY PREDICTS IMPROVED OUTCOMES Reuben Ben David, Shivaram Cumarasamy, Parissa Alerasool, Neeraja Tillu, Jordan M. Rich, Basil Kaufmann, Kyrollis Attalla, Matthew D. Galsky, Reza Mehrazin, Peter Wiklund, and John P. Sfakianos Reuben Ben DavidReuben Ben David , Shivaram CumarasamyShivaram Cumarasamy , Parissa AlerasoolParissa Alerasool , Neeraja TilluNeeraja Tillu , Jordan M. RichJordan M. Rich , Basil KaufmannBasil Kaufmann , Kyrollis AttallaKyrollis Attalla , Matthew D. GalskyMatthew D. Galsky , Reza MehrazinReza Mehrazin , Peter WiklundPeter Wiklund , and John P. SfakianosJohn P. Sfakianos View All Author Informationhttps://doi.org/10.1097/01.JU.0001009424.64728.0c.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Neoadjuvant and adjuvant treatment for patients with bladder cancer undergoing radical cystectomy are currently decided upon using clinical staging. Circulating tumor DNA (ctDNA) has emerged as a possible biomarker for predicting disease outcomes and tailoring such treatments. We seek to assess whether the detection of ctDNA status before and after radical cystectomy is associated with disease recurrence. METHODS: Retrospective investigation of longitudinal bespoke serial ctDNA analyses (SignateraTM) in consecutive patients who underwent robotic-assisted radical cystectomy in a single center. Recurrence free survival was assessed using the Kaplan-Meier method. Cox proportional hazards (CoxPH) analysis was used to find predictors for disease recurrence. Baseline characteristics, pathological, and oncological results were collected from electronic medical records. A p-value of<0.05 was considered statistically significant. R programming language version 4.3 was used for all statistical analyses. RESULTS: Eighty-seven patients were analyzed. The median age was 71 years (IQR 64-78), and 18 were females (20.7%). The median follow-up period was 8 months (IQR 4–12). Preoperative positive ctDNA status was found in 45 patients (51%), and of them 11 patients had non muscle invasive disease (24%). Disease progression was more common in the preoperative positive ctDNA status (41.5% vs 12.2%, p=0.005), and was associated with higher risk of disease relapse (log-rank, p<0.001, Figure 1A). Negative preoperative ctDNA status was associated with lower risk of recurrence regardless of precystectomy disease stage (Figure 1B) or neoadjuvant treatment (Fig 1C). CoxPH analysis revealed that negative ctDNA status during the surveillance period was predictive of decreased risk of disease relapse (HR=0.07, 95% CI0.01-0.64, p=0.019). CONCLUSIONS: Preoperative ctDNA status is associated with disease relapse after radical cystectomy regardless of disease stage and neoadjuvant treatment. ctDNA status holds the promise of informing urologists and oncologists of disease status for optimally selecting patients for neoadjuvant, adjuvant, and treatment escalation regardless of disease stage. A negative preoperative ctDNA could be a marker for treatment deescalation, treating patients only with radical cystectomy. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e806 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Reuben Ben David More articles by this author Shivaram Cumarasamy More articles by this author Parissa Alerasool More articles by this author Neeraja Tillu More articles by this author Jordan M. Rich More articles by this author Basil Kaufmann More articles by this author Kyrollis Attalla More articles by this author Matthew D. Galsky More articles by this author Reza Mehrazin More articles by this author Peter Wiklund More articles by this author John P. Sfakianos More articles by this author Expand All Advertisement PDF downloadLoading ...