Pd02-08 Real World Single-Center Experience of Ctdna as a Prognostic Biomarker in Upper and Lower Tract Urothelial Carcinoma

You have accessJournal of UrologyBladder Cancer: Invasive I (PD02)1 May 2024PD02-08 REAL WORLD SINGLE-CENTER EXPERIENCE OF CTDNA AS A PROGNOSTIC BIOMARKER IN UPPER AND LOWER TRACT UROTHELIAL CARCINOMA Kit L. Yuen, Margaret Meagher, Dhruv Puri, Aditya Bagrodia, Amirali Salmasi, and Tyler Stewart Kit L. YuenKit L. Yuen , Margaret MeagherMargaret Meagher , Dhruv PuriDhruv Puri , Aditya BagrodiaAditya Bagrodia , Amirali SalmasiAmirali Salmasi , and Tyler StewartTyler Stewart View All Author Informationhttps://doi.org/10.1097/01.JU.0001008836.73392.92.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recurrence rates in patients with locally advanced UC after radical surgery (cystectomy (RC) and nephroureterectomy (NU)) remain high with a recurrence rate of up to 50%. Emerging evidence for ultrasensitive ctDNA assays to predict relapse has been promising, and may optimally select patient for perioperative systemic treatment. Previous studies using tumor-informed ctDNA have shown that minimal residual disease (MRD) assessment may be informative in the post-operative period and aid in clinical treatment decision-making. METHODS: We conducted a retrospective single institution analysis of patients who were diagnosed with locally advanced (≥T2 or LN+) upper (UTUC) or lower tract urothelial carcinoma (LTUC), underwent radical resection (RC or NU), had real-world data from commercial ctDNA testing using a personalized, tumor-informed assay (SignateraTM, Natera, Inc.) and had at least 90 days of follow up after surgery. Our primary outcome was detection of non-urinary tract disease free survival (nonUT-DFS). Data was collected on patient demographics, clinical and pathological staging, histologic type, and treatments. Univariate analysis was performed and Kaplan-Meier analysis (KMA) was used to assess nonUT-DFS. We defined a minimal residual disease (MRD) window as any time after surgery within 12 weeks. RESULTS: 37 were included in the analysis. The majority of the patients (16, 80.0%) were male, with a median age of (74, range: 68–76). Median follow-up was 12.2, range: 8.8–17.4 months. Twenty-five (64%) patients had LTUC. Eleven (28%) had mixed or pure variant histology. Four (11%) patients were not able to have an MRD assay constructed due to lack of sufficient tissue. 27 patients had ctDNA testing in the MRD window, and 7 were ctDNA-positive. 100% of patients who had ctDNA-positive in MRD window developed recurrence, while only 3 of 20 (15%) who were ctDNA-negative in the MRD window developed recurrence. 13 patients had ctDNA-positive at any time post-op, and 10 have developed recurrence to date (77%). 20 patients have had only ctDNA-negative, and of these, 2 developed disease recurrence (10%). Interestingly, both patients who developed recurrence in the setting of ctDNA-negative testing developed recurrence predominantly in the peritoneum and surgical bed. CONCLUSIONS: In this real-world data analysis, ctDNA during the MRD and surveillance windows appears to be significantly associated with non-urinary tract DFS. This is an emerging potential biomarker fordetecting non-urinary recurrences and can be used to guide patient management in the post-surgical period. Download PPT Source of Funding: NA © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e73 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kit L. Yuen More articles by this author Margaret Meagher More articles by this author Dhruv Puri More articles by this author Aditya Bagrodia More articles by this author Amirali Salmasi More articles by this author Tyler Stewart More articles by this author Expand All Advertisement PDF downloadLoading ...