Department of Urology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Institute of Tumor Biology Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
World J Urol. 2019 Sep;37(9):1785-1799. doi: 10.1007/s00345-018-2543-9. Epub 2018 Oct 26.
Urothelial carcinoma of the bladder (UCB) is clinically and genetically a highly heterogeneous disease. Treatment decisions are usually based on histopathological workup and molecular diagnostics on tissue biopsies of the primary tumor or the metastatic site. Next to completely different molecular genotypes of phenotypically similar tumors, standard biopsies do not unconditionally allow real-time insight during the natural course of disease progression. Indeed, in UCB there is an imperative need of biomarkers for improving clinical staging, detecting minimal residual disease, predicting therapy response and prognosis and finally enabling patient stratification for multimodal, individualized treatment and therapy monitoring.Liquid biopsies of blood-based circulating biomarkers have evolved from bench to bedside in some cancer entities.
In a narrative review we are summerizing the latest evidence on CTC and ctDNA in muscle-invasive and metastatic UCB.
In this review, we summarize the current status, limitations and future needs of circulating tumor cells (CTC) and cell-free circulating tumor DNA (ctDNA) in UCB. Moreover, we discuss the potential clinical application of CTC and ctDNA as prognostic markers at different UCB stages and their value for target therapy guidance.
CTC and ctDNA are promising circulating biomarkers in UCB, but none of both has progressed from bench to bedside yet. These markers may support outcome prognostication, patient counseling follow-up monitoring, and potentially decision-making regarding chemotherapy. Further prospective clinical or randomized studies are urgently warranted.
膀胱癌（UCB）在临床上和遗传学上是一种高度异质性的疾病。治疗决策通常基于组织活检的组织学检查和分子诊断，包括原发性肿瘤或转移部位。除了表型相似的肿瘤具有完全不同的分子基因型外，标准活检并不能无条件地实时洞察疾病进展的自然过程。事实上，在 UCB 中，迫切需要生物标志物来改善临床分期、检测微小残留疾病、预测治疗反应和预后，并最终能够对患者进行分层，以实现多模式、个体化治疗和治疗监测。基于血液的循环生物标志物的液体活检已经从实验室发展到临床应用于一些癌症实体瘤。
在一篇叙述性综述中，我们总结了肌肉浸润性和转移性 UCB 中循环肿瘤细胞（CTC）和游离循环肿瘤 DNA（ctDNA）的最新证据。
在这篇综述中，我们总结了循环肿瘤细胞（CTC）和游离循环肿瘤 DNA（ctDNA）在 UCB 中的当前状态、局限性和未来需求。此外，我们还讨论了 CTC 和 ctDNA 作为不同 UCB 阶段预后标志物的潜在临床应用及其在靶向治疗指导中的价值。
CTC 和 ctDNA 是 UCB 中很有前途的循环生物标志物，但两者都尚未从实验室发展到临床应用。这些标志物可能支持预后预测、患者咨询随访监测，并可能有助于化疗决策。迫切需要进一步的前瞻性临床或随机研究。
