Urinary tumor DNA (utDNA) and circulating tumor DNA (ctDNA) in patients (pts) with muscle-invasive bladder cancer (MIBC) who received perioperative durvalumab (D) in NIAGARA.
Rattachement africain : nl, us, es, gb, jp, it, vn, ru, ca. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
636 Background: In NIAGARA (NCT03732677), addition of perioperative D to neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) demonstrated a significant improvement in event-free survival (EFS) and overall survival and a numerical increase in pathological complete response (pCR) vs NAC and RC alone in pts with MIBC. In a prior exploratory analysis, negative plasma ctDNA status after neoadjuvant treatment prior to RC (pre-RC) was associated with prolonged EFS but not pCR. Here we assess utDNA as a complementary approach in this setting. Methods: Cisplatin-eligible pts with MIBC (cT2-T4aN0/1M0) were randomized 1:1 to receive perioperative D plus NAC (cisplatin + gemcitabine) and RC (D arm) or NAC and RC alone (comparator [C] arm). Dual primary endpoints were EFS and pCR. Exploratory analysis of utDNA and ctDNA was completed using the personalized Signatera assay (Natera, Inc, Austin, TX, USA) at baseline (BL; n=205) and pre-RC (n=183). Results: Of 1063 pts, 265 (25%) comprised the biomarker-evaluable population (BEP; 134 D arm; 131 C arm). At BL, lower utDNA levels were associated with longer EFS (low vs high utDNA HR 0.65, 95% CI 0.40−1.04). From BL to pre-RC, utDNA+ rate decreased from 85% to 55%. utDNA clearance was associated with longer EFS (HR 0.24, 95% CI 0.09−0.62) and was 12% higher in the D vs C arm (39% vs 27%). Pre-RC utDNA status was associated with a pCR (utDNA−; 72% [55/76] vs utDNA+; 18% [17/96]). Pre-RC utDNA and ctDNA status differentially correlated with disease stage at RC, with utDNA+ correlating with noninvasive disease ( Conclusions: This analysis suggests that lower BL levels and pre-RC clearance of utDNA are associated with better EFS and shows the addition of D to NAC increased utDNA clearance. utDNA status at pre-RC was more closely associated with pCR vs prior findings for ctDNA status. Combined pre-RC ctDNA and utDNA analysis was associated with EFS and may provide complementary insights into disease stage at RC. utDNA status could provide clinically relevant information on the primary bladder tumor, particularly in ctDNA− pts, highlighting the potential value of combining utDNA and ctDNA to inform future management of MIBC. Clinical trial information: NCT03732677 . Pre-RC utDNA and ctDNA correlation with disease stage a at RC. Status n T0N0M0 (%) ≥T2N0M0 (%) T any N+ M+ (%) ctDNA− utDNA− 72 73.6 12.5 12.5 1.4 ctDNA− utDNA+ 62 24.2 30.7 37.1 8.1 ctDNA+ utDNA− 6 16.7 0.0 0.0 83.3 ctDNA+ utDNA+ 33 6.1 0.0 48.5 45.5 a By locally collected pathological assessment.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Urinary tumor DNA (utDNA) and circulating tumor DNA (ctDNA) in patients (pts) with muscle-invasive bladder cancer (MIBC) who received perioperative durvalumab (D) in NIAGARA.
- Date Crossref
- 01/03/2026
- Éditeur
- American Society of Clinical Oncology (ASCO)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Dutch Cancer Society pays non établi dans la noticeInstitution
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The Netherlands Cancer Institute pays non établi dans la noticeÉtablissement de santé
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Tisch Hospital pays non établi dans la noticeÉtablissement de santé
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AstraZeneca (Spain) pays non établi dans la noticeEntreprise
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University of Sheffield Division of Clinical Medicine pays non établi dans la noticeUniversité ou école supérieure
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Northwestern University Robert H. Lurie Comprehensive Cancer Center pays non établi dans la noticeUniversité ou école supérieure
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University of Tsukuba pays non établi dans la noticeUniversité ou école supérieure
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Memorial Sloan Kettering Cancer Center pays non établi dans la noticeÉtablissement de santé
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University of Florence Department of Experimental and Clinical Medicine pays non établi dans la noticeUniversité ou école supérieure
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Vietnam National Children's Hospital pays non établi dans la noticeÉtablissement de santé
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University of Iowa pays non établi dans la noticeUniversité ou école supérieure
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University of Iowa Holden Comprehensive Cancer Center pays non établi dans la noticeÉtablissement de santé
Dutch Cancer Society, The Netherlands Cancer Institute et Tisch Hospital, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.