Liquid biopsies are emerging as valuable tools in bladder cancer care. By analyzing circulating tumor DNA (ctDNA) in blood and urinary tumor DNA (utDNA), doctors can better assess risk and monitor disease compared to traditional methods alone.
Tumor-informed ctDNA tests, such as Signatera, are increasingly used to detect minimal residual disease and guide treatment decisions. Around 30% of localized bladder cancer patients test positive for ctDNA, which strongly predicts the risk of metastasis. Clinical trials showed that patients with cleared utDNA or negative ctDNA had significantly better survival outcomes, while higher tumor DNA levels were linked to poorer prognosis.
Despite their promise, liquid biopsies are not a replacement for standard tools like cystoscopy, as they may miss local recurrences. Ongoing studies, including the MODERN trial, aim to refine how these tests guide treatment decisions after surgery.