OnCo
ideasIdea

Urine tumour DNA to replace surveillance cystoscopy in NMIBC

Bladder cancer sheds DNA straight into urine. A urine test every few months could replace many of the camera examinations patients endure for years.

Urine tumour DNA assays (UroAmp, Bladder EpiCheck, Cxbladder, methylation panels) detect recurrence with sensitivity approaching cystoscopy and can anticipate it by months. Prospective trials of biomarker-guided surveillance intervals are under way.

Hypothesis
A negative urine tumour DNA test allows cystoscopy intervals to be doubled in intermediate-risk NMIBC without an increase in progression to MIBC.
Rationale
Urine has far higher tumour DNA fraction than plasma for bladder cancer; cystoscopy burden and cost are the main drivers of bladder cancer's status as the most expensive cancer per patient.
What would test it
Randomised trial of urine-guided vs fixed-interval cystoscopy with progression as primary endpoint and quality of life secondary.
Maturity
early clinical

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