Circulating tumour DNA and circulating tumour cells in bladder cancer — from discovery to clinical implementation

Abstract

Liquid biopsies, indicating the sampling of body fluids rather than solid-tissue biopsies, have the potential to revolutionize cancer care through personalized, noninvasive disease detection and monitoring. Circulating tumour DNA (ctDNA) and circulating tumour cells (CTCs) are promising blood-based biomarkers in bladder cancer. Results from several studies have shown the clinical potential of ctDNA and CTCs in bladder cancer for prognostication, treatment-response monitoring, and early detection of minimal residual disease and disease recurrence. Following successful clinical trial evaluation, assessment of ctDNA and CTCs holds the potential to transform the therapeutic pathway for patients with bladder cancer — potentially in combination with the analysis of urinary tumour DNA — through tailored treatment guidance and optimized disease surveillance. In this Review, the authors provide an overview of circulating tumour DNA and circulating tumour cells as potential biomarkers to provide therapeutic guidance and optimize disease surveillance in bladder cancer. Challenges associated with these biomarkers and future perspectives for clinical implementation are also discussed.