Evidence map›Paper›PMID 42389921›Full record

ArticleBJU international2026

Longitudinal circulating tumour DNA identifies patients at high risk of upstaging and recurrence in non-muscle-invasive bladder cancer.

Can Aydogdu, Betty Wang, Sean Thomas McSweeney, Gabriela Diaz, Taeris Guzman, Sahab Ram Dewala, Rakesh Arya, Mikayla Baer, Amanda Nizam, Christopher Wee and 8 more

Abstract read
In one paragraph

Article in BJU international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Can AydogduDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0009-0003-1486-183X
Betty WangDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Sean Thomas McSweeneyDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Gabriela DiazDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-7931-252X
Taeris GuzmanDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Sahab Ram DewalaDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Rakesh AryaDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Mikayla BaerDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Amanda NizamDepartment of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
Christopher WeeDepartment of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
Shalini MoningiDepartment of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
Alberto PierettiDepartment of Urology, Cleveland Clinic Florida, Weston Hospital, Weston, FL, USA.
Christopher J WeightDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Rebecca CampbellDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Mohit SindhaniDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Jihad KaoukDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Robert AbouassalyDepartment of Urology, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Laura BukavinaDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate whether longitudinal tumour-informed circulating tumour DNA (ctDNA) testing identifies patients at increased risk of upstaging and recurrence in high-risk non-muscle-invasive bladder cancer (NMIBC). PATIENTS AND

methodsA cohort of 52 patients with high-risk NMIBC underwent serial plasma ctDNA testing using a personalised tumour-informed assay. The ctDNA was obtained at initial presentation and at approximately 3-month surveillance intervals during appropriate routine clinical NMIBC therapy and follow-up. A subset of tumours underwent tumour-normal whole-exome sequencing to evaluate genomic alterations associated with ctDNA detection and clinical progression.

resultsCirculating tumour DNA was detectable in 17 of 52 patients (33%), including eight of 29 who were Bacillus Calmette-Guérin (BCG)-naïve (28%) and nine of 23 who were BCG-exposed/BCG-unresponsive patients (39%). Most patients received intravesical therapy, including BCG or salvage intravesical chemotherapy, and a subset underwent radical cystectomy. Clinical upstaging occurred in 10 of 17 ctDNA-positive patients vs five of 35 ctDNA-negative patients (59% vs 14%, P = 0.002). Among the 21 patients undergoing cystectomy, pathological upstaging occurred in seven of nine ctDNA-positive patients and one of 12 ctDNA-negative patients (78% vs 8%, P = 0.002). Distant recurrence occurred in three of 17 (18%) ctDNA-positive patients and in none of ctDNA-negative patients. TP53 alterations were enriched in ctDNA-positive tumours, whereas fibroblast growth factor receptor (FGFR3) alterations were more frequent in ctDNA-negative tumours. Limitations include the small cohort and limited follow-up.

conclusionLongitudinal ctDNA testing in high-risk NMIBC identifies a subgroup with higher risk of clinical and pathological upstaging and distant recurrence, often without corresponding cystoscopic or radiographic evidence. ctDNA-positivity reflects aggressive tumour biology and may help identify patients unlikely to benefit from continued intravesical salvage therapy. These findings support further evaluation of ctDNA as a potential risk stratification tool and motivate prospective studies of ctDNA-guided management.

Indexed as

Circulating Tumor DNANeoplasm Recurrence, LocalNon-Muscle Invasive Bladder NeoplasmsUrinary Bladder NeoplasmsAdministration, IntravesicalAgedAged, 80 and overBCG VaccineBiomarkers, TumorFemaleHumansMaleMiddle AgedNeoplasm StagingBCG VaccineBiomarkers, TumorCirculating Tumor DNABacillus Calmette–Guérinbiomarkercirculating tumour DNAmolecular residual diseasenon‐muscle‐invasive bladder cancerunresponsiveurothelial carcinoma

Identifiers

PMID42389921
PMCPMC13458655

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.