Researchers looking at a new biomarker of residual bladder cancer have found that it identifies high risk patients who may benefit from additional treatment.
The team, from Queen Mary University of London, UK, searched for a minimally invasive approach to detecting residual disease after cancer surgery. They tested 581 bladder cancer patients and found that those with circulating tumour DNA (ctDNA) were at risk of relapse.
They report that at the start of therapy, patients who were positive for ctDNA had a poorer prognosis but showed better disease-free survival and overall survival if given the drug atezolizumab, a monoclonal antibody.
Whereas no differences were seen between patients who were negative for ctDNA and given atezolizumab or placebo.
"The rate of ctDNA clearance at week six was higher in the atezolizumab arm (18%) than in the observation arm (4%)," they write in Nature on 16 June.
"These data suggest that adjuvant atezolizumab may be associated with improved outcomes compared with observation in patients who are positive for ctDNA and who are at a high risk of relapse," they state. "These findings, if validated in other settings, would shift approaches to postoperative cancer care."
Lead researcher, Professor Tom Powles said: “These novel findings demonstrate ctDNA as a marker for residual disease and response to atezolizumab. We also found ctDNA measurement to be more accurate than traditional radiology at identifying disease relapse.
"These findings may change our understanding of post-surgical cancer care and, if validated in this setting as well as across tumour types, they may also change clinical practice.”
Powles, T. et al. ctDNA guiding adjuvant immunotherapy in urothelial carcinoma. Nature 16 June 2021; doi: 10.1038/s41586-021-03642-9
Leave a Reply