Abstract：
OBJECTIVE: To provide an updated view on the role of cell-free DNA as a predictor of pathological response to neoadjuvant therapy in patients with muscle-invasive bladder cancer.
METHODS: A systematic review was conducted from September 2023 to October 2023. Selected studies from the MEDLINE and clinical trial databases were critically analyzed regarding the clinical efficacy of cell-free DNA as a predictive instrument after neoadjuvant therapy in bladder cancer. The methodological quality assessment was based on the QUADAS-2 tool.
RESULTS: In this systematic review, we analyzed 5 studies encompassing a cumulative patient cohort of 780 individuals diagnosed with muscle-invasive bladder cancer, with a median follow-up ranging from 6 to 23 months. Among these studies, 4 primarily focused on detecting and analyzing circulating tumor DNA in plasma, while 1 study uniquely utilized cell-free tumor DNA in urine samples. The diagnostic accuracy of cell-free DNA in plasma ranges from 79% to 100%, indicating a variable yet significant predictive capability. In contrast, the study utilizing urinary cell-free DNA demonstrated an accuracy of 81% in predicting treatment response post-neoadjuvant chemotherapy.
CONCLUSIONS: Cell-free DNA is emerging as a valuable biomarker for predicting response to neoadjuvant chemotherapy in patients with muscle-invasive bladder tumors.
METHODS: A systematic review was conducted from September 2023 to October 2023. Selected studies from the MEDLINE and clinical trial databases were critically analyzed regarding the clinical efficacy of cell-free DNA as a predictive instrument after neoadjuvant therapy in bladder cancer. The methodological quality assessment was based on the QUADAS-2 tool.
RESULTS: In this systematic review, we analyzed 5 studies encompassing a cumulative patient cohort of 780 individuals diagnosed with muscle-invasive bladder cancer, with a median follow-up ranging from 6 to 23 months. Among these studies, 4 primarily focused on detecting and analyzing circulating tumor DNA in plasma, while 1 study uniquely utilized cell-free tumor DNA in urine samples. The diagnostic accuracy of cell-free DNA in plasma ranges from 79% to 100%, indicating a variable yet significant predictive capability. In contrast, the study utilizing urinary cell-free DNA demonstrated an accuracy of 81% in predicting treatment response post-neoadjuvant chemotherapy.
CONCLUSIONS: Cell-free DNA is emerging as a valuable biomarker for predicting response to neoadjuvant chemotherapy in patients with muscle-invasive bladder tumors.
摘要：
目的：提供关于无细胞DNA作为预测肌层浸润性膀胱癌患者新辅助治疗病理反应的作用的最新观点。
方法：从2023年9月至2023年10月进行了系统评价。对MEDLINE和临床试验数据库中的选定研究进行了严格分析，以评估膀胱癌新辅助治疗后无细胞DNA作为预测工具的临床疗效。方法学质量评估基于QUADAS-2工具。
结果：在本系统综述中，我们分析了5项研究，包括780名诊断为肌肉浸润性膀胱癌的患者的累积队列，中位随访时间为6至23个月。在这些研究中,4主要集中于检测和分析血浆中的循环肿瘤DNA，而一项研究独特地利用了尿液样本中的无细胞肿瘤DNA。血浆中无细胞DNA的诊断准确率为79％至100％，表明变量但具有重要的预测能力。相比之下,这项利用尿无细胞DNA的研究显示,在预测新辅助化疗后治疗反应方面的准确率为81%.
结论：无细胞DNA正在成为预测肌肉浸润性膀胱肿瘤患者对新辅助化疗反应的有价值的生物标志物。
方法：从2023年9月至2023年10月进行了系统评价。对MEDLINE和临床试验数据库中的选定研究进行了严格分析，以评估膀胱癌新辅助治疗后无细胞DNA作为预测工具的临床疗效。方法学质量评估基于QUADAS-2工具。
结果：在本系统综述中，我们分析了5项研究，包括780名诊断为肌肉浸润性膀胱癌的患者的累积队列，中位随访时间为6至23个月。在这些研究中,4主要集中于检测和分析血浆中的循环肿瘤DNA，而一项研究独特地利用了尿液样本中的无细胞肿瘤DNA。血浆中无细胞DNA的诊断准确率为79％至100％，表明变量但具有重要的预测能力。相比之下,这项利用尿无细胞DNA的研究显示,在预测新辅助化疗后治疗反应方面的准确率为81%.
结论：无细胞DNA正在成为预测肌肉浸润性膀胱肿瘤患者对新辅助化疗反应的有价值的生物标志物。
