Mapping ctDNA Shedding Differences in GU Cancers With MRD Testing
Arnab Basu, MD, MPH, FACP, explains why sensitivity might be higher in urothelial cancer vs other genitourinary cancers.
Arnab Basu, MD, MPH, FACP, assistant professor in genitourinary medical oncology at the University of Alabama in Birmingham, explains why sensitivity might be higher in urothelial cancer vs other genitourinary (GU) cancers.
Basu has focused his research on using high-sensitivity circulating tumor DNA (ctDNA) assays, specifically minimal residual disease (MRD) tests, in detecting micrometastatic disease across various GU malignancies, including kidney, bladder, and prostate cancers. His research is a mix of retrospective and prospective studies, primarily in urothelial carcinoma but also involving cancers like penile, urethral, and renal cell carcinoma, showing promising results.
In his studies, Basu found that the sensitivity of MRD assays can vary among GU cancers due to biological differences in tumor types. Urothelial carcinoma, for example, is highly aggressive and sheds more DNA into circulation compared with other GU cancers like prostate cancer, which sheds less DNA. This is especially true for prostate cancer in its localized form.
Moreover, Basu’s retrospective studies reveal these shedding differences across tumor types, highlighting ctDNA’s utility and limitations in GU oncology and guiding future research.
Transcription:
0:09 | MRD assays are currently the best that we have right now in terms of the sensitivity of detecting circulating tumor DNA. However, different diseases have different kinds of biology. A urothelial carcinoma tends to be a lot more aggressive than a favorable-risk renal cell carcinoma. The turnover is high, and there is also, potentially, more shedding of DNA into the circulation.
0:42 | Certain tumor types tend to shed more than others[due to] squamous differentiation, so squamous tumors shed DNA. Prostate does not shed as much. For localized prostate, there is not a lot of great data, and that is what my fellow colleagues and I put together. We have done a lot of retrospective studies in the clinic showing these kinds of differences.
