Urine-based Tumor DNA Testing Enhances Personalization of Bladder Cancer Treatment

Recent research published in the European Urology journal highlights the potential of urine-based tumor DNA (utDNA) testing to revolutionize bladder cancer management. This multi-institutional study demonstrates that analyzing utDNA can serve as a predictive marker for treatment response and recurrence risk in bladder cancer patients, especially those receiving immunotherapy. The study involved collecting urine samples from patients participating in the SWOG S1605 trial, which tested the effectiveness of atezolizumab, an immunotherapy drug, in treating high-risk bladder cancer unresponsive to BCG therapy.

Researchers used a noninvasive urine test called UroAmp to examine utDNA at the start of treatment and after three months. The test detects genetic mutations associated with bladder cancer within the urine, enabling a detailed genomic profile for each patient. Findings showed that utDNA levels correlated with patient outcomes: higher or persistent utDNA was linked to poorer responses to therapy and increased chances of cancer recurrence over an 18-month follow-up. Specifically, patients with positive utDNA results were less likely to respond to treatment and more prone to relapse.

Bladder cancer ranks as the sixth most common cancer in the United States, with over 83,000 new cases annually. Most cases are non-muscle invasive at diagnosis, yet treatment responses vary widely. For patients who do not respond to immunotherapy, choices often involve either continued bladder-sparing therapies with high recurrence risks or invasive surgical removal of the bladder, significantly impacting quality of life.

This groundbreaking study offers a promising approach for early prediction of treatment success through a simple urine test. By identifying patients likely to benefit from immunotherapy early on, clinicians can tailor personalized treatment strategies, potentially avoiding unnecessary surgeries and improving overall outcomes. This advancement underscores the move toward more precise, less invasive cancer management and personalized medicine in urology.

Source: https://medicalxpress.com/news/2025-06-urine-based-tumor-dna-personalize.html