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Tumor DNA May Predict Outcomes to Presurgical Treatment in Patients with Bladder Cancer


Data suggests an association between tumor DNA circulating in plasma and patient responses to neoadjuvant treatment.

The absence of ctDNA (fragments of cancer DNA) in plasma, which was detected by RaDaR assay, was associated with patient responses to treatment with neoadjuvant (presurgical) therapy in bladder cancer, according to a press release from NEO Genomics, the manufacturer of RaDaR.

Results demonstrated that 43% of patients in the stage 2A group and 7% of patients in the stage 2B group achieved a complete pathological response (the disappearance of cancer as a response to treatment). Moreover, the absence of ctDNA in blood plasma was highlight associated with a complete pathological response and progression-free survival (time during and after treatment when the patient lives without disease progression).

These results are part of a phase 1b/2a trial which evaluated patient response to neoadjuvant treatment with a CTLA-4 inhibitor (Yervoy [ipilimumab]) in combination with a PD-L1 inhibitor (Opdivo [nivolumab]). RaDaR was used before and during treatment.

The RaDaR assay is a personalized, highly sensitive sequencing test to detect minimal residual disease and recurrence. Of note, minimal residual disease is the amount of tumor DNA that is still in the body after surgery or other treatment.

"Although cisplatin-based chemotherapy plus radical cystectomy remains the currently recommended treatment for muscle-invasive bladder cancer, there are some patients who are not eligible to receive chemotherapy and the prognosis for this patient population is poor," said Shashikant Kulkarni, Chief Scientific Officer, NeoGenomics. "The findings from the NABUCCO trial offer initial evidence in hopefully improving the outlook for these patients. Importantly, the research shows that the RaDaR assay can be used successfully to guide decision-making and help oncologists personalize patient care based on their risk of recurrence."

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