Molecular markers in disease detection and follow-up of patients with non-muscle invasive bladder cancer

ABSTRACT

Introduction: Diagnosis and surveillance of non-muscle invasive bladder cancer (NMIBC) is mainly based on endoscopic bladder evaluation and urine cytology. Several assays for determining additional molecular markers (urine-, tissue- or blood-based) have been developed in recent years but have not been included in clinical guidelines so far.

Areas covered: This review gives an update on different molecular markers in the urine and evaluates their role in patients with NMIBC in disease detection and surveillance. Moreover, the potential of recent approaches such as DNA methylation assays, multi-panel RNA gene expression assays and cell-free DNA analysis is assessed.

Expert commentary: Most studies on various molecular urine markers have mainly focused on a potential replacement of cystoscopy. New developments in high throughput technologies and urine markers may offer further advantages as they may represent a non-invasive approach for molecular characterization of the disease. This opens new options for individualized surveillance strategies and may help to choose the best therapeutic option. The implementation of these technologies in well-designed clinical trials is essential to further promote the use of urine diagnostics in the management of patients with NMIBC.

KEYWORDS:

• Molecular urine markers
• non-muscle invasive bladder cancer
• disease detection
• follow-up
• cell-free DNA

Declaration of interest

T. Todenhöfer serves as a consultant for Ipsen and has scientific cooperations with IDL and Qiagen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. A peer reviewer on the manuscript has disclosed the lab group they collaborate with has IP interests in urinary biomarkers, though they have no direct IP interest themselves.

Additional information

Funding

This paper was not funded.