Utilizing Cell-Free Urinary and Plasma Tumor DNA to Predict Pathologic Stage at Radical Cystectomy

ObjectiveTo assess the ability of cell-free urinary and plasma tumor DNA (cfDNA) to predict pathologic stage at radical cystectomy for patients with clinical muscle-invasive bladder cancer. MethodsA total of 25 patients with clinical muscle-invasive bladder cancer were enrolled before undergoing ra...

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Main Authors: Prithvi B. Murthy, Billie Gould, Facundo Davaro, Pan Du, Lucia Camperlengo, Shreyas Naidu, Kyle Rose, Scott M. Gilbert, Philippe E. Spiess, Wade Sexton, G. Daniel Grass, Rohit Jain, Xuefeng Wang, Joshua J. Meeks, Andrea Necchi, Liang Cheng, Shidong Jia, Roger Li
Format: Article
Language:English
Published: The Société Internationale d’Urologie (SIU) 2023-07-01
Series:Société Internationale d’Urologie Journal
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Online Access:https://siuj.org/index.php/siuj/article/view/278/223
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author Prithvi B. Murthy
Billie Gould
Facundo Davaro
Pan Du
Lucia Camperlengo
Shreyas Naidu
Kyle Rose
Scott M. Gilbert
Philippe E. Spiess
Wade Sexton
G. Daniel Grass
Rohit Jain
Xuefeng Wang
Joshua J. Meeks
Andrea Necchi
Liang Cheng
Shidong Jia
Roger Li
author_facet Prithvi B. Murthy
Billie Gould
Facundo Davaro
Pan Du
Lucia Camperlengo
Shreyas Naidu
Kyle Rose
Scott M. Gilbert
Philippe E. Spiess
Wade Sexton
G. Daniel Grass
Rohit Jain
Xuefeng Wang
Joshua J. Meeks
Andrea Necchi
Liang Cheng
Shidong Jia
Roger Li
author_sort Prithvi B. Murthy
collection DOAJ
description ObjectiveTo assess the ability of cell-free urinary and plasma tumor DNA (cfDNA) to predict pathologic stage at radical cystectomy for patients with clinical muscle-invasive bladder cancer. MethodsA total of 25 patients with clinical muscle-invasive bladder cancer were enrolled before undergoing radical cystectomy. Blood and urine were collected before surgery. The 600-gene PredicineATLAS panel was used to sequence blood buffy-coat germline DNA, plasma cfDNA, and urine cfDNA samples. Low-pass whole genome sequencing was performed on plasma- and urine-derived cfDNA. CfDNA tumor fraction (TF), genome-wide copy number burden (CNB), and estimated tumor mutational burden (TMB) were measured in both plasma and urine samples and their correlation with pathologic T-stage was examined. ResultsThree of 25 plasma samples had insufficient cfDNA. In 22 of 22 plasma samples and 24 of 25 urine samples, at least one nonsynonymous somatic variant was detected. Across the cohort, 44% of plasma variants were concordant with paired urine variants. The mean number of variants did not differ between noninvasive (< pT1/pN0) and invasive disease (≥ pT1 or N+) for both plasma (8 vs. 9.5 variants; P = 0.85) and urine (33.7 vs. 30 variants; P = 0.45). A strong correlation was observed between urine TF and urine CNB score within patients (rv = 0.92). Plasma TF (r = 0.38), urine TF (r = 0.21), and urine CNB score (r = 0.16) exhibited positive correlations with pT stage. Patients with carcinoma in situ (CIS) had higher mean urine TF and CNB scores ( P = 0.07 and P = 0.05, respectively). Plasma TF and CNB score did not correlate with the presence of CIS. ConclusionsCombining plasma- and urine-based cfDNA analysis may help identify patients with residual disease at radical, although we were unable to predict pathologic T-stage based on these metrics.The presence of CIS may contribute to greater urinary CNB and TF levels. Considering CIS in the analysis may improve the ability to correlate tumor metrics with pathologic stage. Low-pass whole genome sequencing–derived urinary CNB correlates strongly with urinary TF and may provide a less resource-intensive method for future longitudinal disease monitoring.
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spelling doaj.art-e21c4b30c47c4ff6a6c209b651a5528c2023-12-29T22:48:51ZengThe Société Internationale d’Urologie (SIU)Société Internationale d’Urologie Journal2563-64992023-07-014424725610.48083/WJMB7232 Utilizing Cell-Free Urinary and Plasma Tumor DNA to Predict Pathologic Stage at Radical CystectomyPrithvi B. MurthyBillie GouldFacundo DavaroPan DuLucia CamperlengoShreyas NaiduKyle RoseScott M. GilbertPhilippe E. SpiessWade SextonG. Daniel GrassRohit JainXuefeng WangJoshua J. MeeksAndrea NecchiLiang ChengShidong JiaRoger LiObjectiveTo assess the ability of cell-free urinary and plasma tumor DNA (cfDNA) to predict pathologic stage at radical cystectomy for patients with clinical muscle-invasive bladder cancer. MethodsA total of 25 patients with clinical muscle-invasive bladder cancer were enrolled before undergoing radical cystectomy. Blood and urine were collected before surgery. The 600-gene PredicineATLAS panel was used to sequence blood buffy-coat germline DNA, plasma cfDNA, and urine cfDNA samples. Low-pass whole genome sequencing was performed on plasma- and urine-derived cfDNA. CfDNA tumor fraction (TF), genome-wide copy number burden (CNB), and estimated tumor mutational burden (TMB) were measured in both plasma and urine samples and their correlation with pathologic T-stage was examined. ResultsThree of 25 plasma samples had insufficient cfDNA. In 22 of 22 plasma samples and 24 of 25 urine samples, at least one nonsynonymous somatic variant was detected. Across the cohort, 44% of plasma variants were concordant with paired urine variants. The mean number of variants did not differ between noninvasive (< pT1/pN0) and invasive disease (≥ pT1 or N+) for both plasma (8 vs. 9.5 variants; P = 0.85) and urine (33.7 vs. 30 variants; P = 0.45). A strong correlation was observed between urine TF and urine CNB score within patients (rv = 0.92). Plasma TF (r = 0.38), urine TF (r = 0.21), and urine CNB score (r = 0.16) exhibited positive correlations with pT stage. Patients with carcinoma in situ (CIS) had higher mean urine TF and CNB scores ( P = 0.07 and P = 0.05, respectively). Plasma TF and CNB score did not correlate with the presence of CIS. ConclusionsCombining plasma- and urine-based cfDNA analysis may help identify patients with residual disease at radical, although we were unable to predict pathologic T-stage based on these metrics.The presence of CIS may contribute to greater urinary CNB and TF levels. Considering CIS in the analysis may improve the ability to correlate tumor metrics with pathologic stage. Low-pass whole genome sequencing–derived urinary CNB correlates strongly with urinary TF and may provide a less resource-intensive method for future longitudinal disease monitoring. https://siuj.org/index.php/siuj/article/view/278/223bladder cancerminimal residual diseasenext generation sequencingcell-free dnacirculating tumor dnaurinary tumor dna
spellingShingle Prithvi B. Murthy
Billie Gould
Facundo Davaro
Pan Du
Lucia Camperlengo
Shreyas Naidu
Kyle Rose
Scott M. Gilbert
Philippe E. Spiess
Wade Sexton
G. Daniel Grass
Rohit Jain
Xuefeng Wang
Joshua J. Meeks
Andrea Necchi
Liang Cheng
Shidong Jia
Roger Li
Utilizing Cell-Free Urinary and Plasma Tumor DNA to Predict Pathologic Stage at Radical Cystectomy
Société Internationale d’Urologie Journal
bladder cancer
minimal residual disease
next generation sequencing
cell-free dna
circulating tumor dna
urinary tumor dna
title Utilizing Cell-Free Urinary and Plasma Tumor DNA to Predict Pathologic Stage at Radical Cystectomy
title_full Utilizing Cell-Free Urinary and Plasma Tumor DNA to Predict Pathologic Stage at Radical Cystectomy
title_fullStr Utilizing Cell-Free Urinary and Plasma Tumor DNA to Predict Pathologic Stage at Radical Cystectomy
title_full_unstemmed Utilizing Cell-Free Urinary and Plasma Tumor DNA to Predict Pathologic Stage at Radical Cystectomy
title_short Utilizing Cell-Free Urinary and Plasma Tumor DNA to Predict Pathologic Stage at Radical Cystectomy
title_sort utilizing cell free urinary and plasma tumor dna to predict pathologic stage at radical cystectomy
topic bladder cancer
minimal residual disease
next generation sequencing
cell-free dna
circulating tumor dna
urinary tumor dna
url https://siuj.org/index.php/siuj/article/view/278/223
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