PDF(Pubmed)
Abstract：
In the recent decade, analysis of circulating tumor DNA (ctDNA) has improved cancer care by allowing for rapid detection of actionable molecular targets. A new generation of circulating DNA tests is now becoming available commercially. These tests are characterized by a superior limit of detection of 0.01% vaF or better, allowing for the detection of radiologically occult molecular residual disease (MRD). MRD tests have the potential to revolutionize neoadjuvant and adjuvant treatment. In addition, these tests can be used as tumor markers to assess disease response. We reviewed the current evidence for the use of high-sensitivity MRD assays with particular focus on the genitourinary tumors. Multiple studies have now been reported in urothelial, renal, and recently testicular carcinoma. We find that the sensitivity varies across tumor types in the adjuvant setting and may reach a high of 100% in urothelial cancer. Specificity in tumor-informed MRD appears to be preserved across tumor types (98%-100%). Several trials are now prospectively validating MRD testing in biomarker integral studies, mainly in urothelial carcinoma.
摘要：
在最近的十年里,循环肿瘤DNA（ctDNA）的分析通过允许快速检测可操作的分子靶标来改善癌症治疗。新一代的循环DNA测试现在正在商业化。这些测试的特点是0.01％vaF或更好的检测极限，允许检测放射学隐匿性分子残留病（MRD）。MRD测试有可能彻底改变新辅助和辅助治疗。此外,这些测试可用作肿瘤标志物来评估疾病反应。我们回顾了目前使用高灵敏度MRD测定的证据，特别关注泌尿生殖系统肿瘤。现在已经报道了在尿路上皮的多项研究，肾,最近还有睾丸癌.我们发现，在佐剂设置中，敏感性因肿瘤类型而异，在尿路上皮癌中可能达到100％的高水平。肿瘤知情MRD的特异性似乎在肿瘤类型中保留(98%-100%)。现在有几项试验正在前瞻性地验证生物标志物积分研究中的MRD测试，主要见于尿路上皮癌。
