Mp38-04 Prediction of Recurrence Using Case-Specific Circulating Tumor Dna in Postoperative Patients With Upper Tract Urothelial Carcinoma

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP38)1 May 2024MP38-04 PREDICTION OF RECURRENCE USING CASE-SPECIFIC CIRCULATING TUMOR DNA IN POSTOPERATIVE PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA Daichi Tamura, Masakazu Abe, Daiki Ikarashi, Renpei Kato, Shigekatsu Maekawa, Yutaka Suzuki, Hidewaki Nakagawa, and Wataru Obara Daichi TamuraDaichi Tamura , Masakazu AbeMasakazu Abe , Daiki IkarashiDaiki Ikarashi , Renpei KatoRenpei Kato , Shigekatsu MaekawaShigekatsu Maekawa , Yutaka SuzukiYutaka Suzuki , Hidewaki NakagawaHidewaki Nakagawa , and Wataru ObaraWataru Obara View All Author Informationhttps://doi.org/10.1097/01.JU.0001008700.92603.b1.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Current standard methods for the diagnosis and detection of recurrence in patients with upper tract urothelial carcinoma (UTUC) are invasive or low sensitivity. Circulating tumor DNA (ctDNA) analysis using digital polymerase chain reaction (dPCR) has demonstrated promising results for monitoring as recurrence in several cancers. The aim of this study was to evaluate the validity of plasma and urinary circulating tumor DNA (ctDNA) as tumor biomarker for UTUC during the perioperative period. METHODS: This study included 31 patients who underwent radical nephroureterectomy (RNU) for UTUC from January 2019 to March 2022. In each patient, whole-exome sequencing (WES) and TERT promoter sequencing of tumor DNA and corresponding peripheral blood mononuclear cell (PBMC) DNA were performed by next-generation sequencing. We selected case-specific gene mutations, and also collected plasma and urine ctDNA from each patient. The longitudinal variant allele frequencies of ctDNA during the perioperative period were plotted using digital PCR. RESULTS: The median age was 71 years (range 55-82). 19 cases were renal pelvic cancer, and 12 cases were ureteral cancer. The most frequently selected genes as case-specific mutations were TERT (52%), FGFR3 (29%), TP53 (16%). 17 cases (55%) experienced bladder recurrence or metastatic disease after RNU. The median recurrence-free survival (RFS) was 21.9 months. The rate of change in urinary ctDNA VAFs between pre-RNU and day2 after RNU was significantly higher in the recurrence group than in the non-recurrence group (33.9% vs. −99.6%, p=0.041). In univariate analysis, we identified the change rate of urinary ctDNA, pT≥2, and presense of TP53 mutations as prognostic factors associated with short RFS. In the multivariate analysis, the rate of change in urinary ctDNA was identified as a prognostic factor associated with short RFS. CONCLUSIONS: Individualized ctDNA monitoring could be a useful biomarker for postoperative recurrence. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e641 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Daichi Tamura More articles by this author Masakazu Abe More articles by this author Daiki Ikarashi More articles by this author Renpei Kato More articles by this author Shigekatsu Maekawa More articles by this author Yutaka Suzuki More articles by this author Hidewaki Nakagawa More articles by this author Wataru Obara More articles by this author Expand All Advertisement PDF downloadLoading ...