Dr. Powles on the Role of ctDNA Positivity in High-Risk Muscle-Invasive Urothelial Cancer

Thomas Powles, MBBS, MRCP, MD, director, Barts Cancer Institute, discusses the role of circulating tumor DNA (ctDNA) positivity in high-risk muscle-invasive urothelial cancer.

During the ESMO Immuno-Oncology Virtual Congress 2020, findings from an analysis of the phase 3 IMvigor010 trial showed that patients with ctDNA-positive disease were significantly more likely to relapse compared with patients with ctDNA-negative disease, indicating that ctDNA can be used as a prognostic biomarker, Powles explains. Notably, patients with ctDNA-positive urothelial cancer have about an 80% chance of disease recurrence, says Powles.

Additionally, the analysis demonstrated that ctDNA positivity identified patients with high-risk muscle-invasive disease who were likely to derive improvements in disease-free survival and overall survival from adjuvant atezolizumab (Tecentriq) compared with observation. Furthermore, adjuvant atezolizumab yielded around a 45% reduction in the risk of relapse and death in the population of patients with minimal residual disease who have a high risk of recurrence, concludes Powles.