%0 Journal Article
%T Honing the Hunt: A Comprehensive Review of Cell-free Tumor DNA to Predict Neoadjuvant Therapy Efficacy in Bladder Cancer.
%A Suartz CV
%A Martinez LM
%A Cordeiro MD
%A Botelho LAA
%A Gallutti FP
%A Mota JM
%A Leite KRM
%A Toren P
%A Nahas WC
%A Ribeiro-Filho LA
%J Clin Genitourin Cancer
%V 22
%N 3
%D 2024 Jun 6
%M 38688207
%F 3.121
%R 10.1016/j.clgc.2024.102087
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>Cell-free DNA is emerging as a valuable biomarker for predicting response to neoadjuvant chemotherapy in patients with muscle-invasive bladder tumors.