Blood-based liquid biopsy: insights into early detection, prediction, and treatment monitoring of bladder cancer

Abstract

Bladder cancer (BC) is a clinical challenge worldwide with late clinical presentation, poor prognosis, and low survival rates. Traditional cystoscopy and tissue biopsy are routine methods for the diagnosis, prognosis, and monitoring of BC. However, due to the heterogeneity and limitations of tumors, such as aggressiveness, high cost, and limited applicability of longitudinal surveillance, the identification of tumor markers has attracted significant attention in BC. Over the past decade, liquid biopsies (e.g., blood) have proven to be highly efficient methods for the discovery of BC biomarkers. This noninvasive sampling method is used to analyze unique tumor components released into the peripheral circulation and allows serial sampling and longitudinal monitoring of tumor progression. Several liquid biopsy biomarkers are being extensively studied and have shown promising results in clinical applications of BC, including early detection, detection of microscopic residual disease, prediction of recurrence, and response to therapy. Therefore, in this review, we aim to provide an update on various novel blood-based liquid biopsy markers and review the advantages and current limitations of liquid biopsy in BC therapy. The role of blood-based circulating tumor cells, circulating tumor DNA, cell-free RNA, exosomes, metabolomics, and proteomics in diagnosis, prognosis, and treatment monitoring, and their applicability to the personalized management of BC, are highlighted.

A Large Genetic Causal Analysis of the Gut Microbiota and Urological Cancers: A Bidirectional Mendelian Randomization Study

“…Currently, cystoscopy and bladder tissue biopsy are considered to be the gold standard for bladder cancer diagnosis [ 68 ]. However, both examinations are invasive, limiting their use in large-scale screening [ 7 ]. In recent years, serum prostate-specific antigen (PSA) has been widely used for screening and early detection of prostate cancer due to its non-invasive advantages [ 69 ].…”

“…Compared to other cancers, urological cancers develop slowly and can easily be cured by early detection and treatment [ 6 ]. However, the early symptoms of urological cancers are not obvious, and cystoscopy, tissue biopsy, and imaging examinations limit their use in large-scale screening due to invasiveness, cost, and ionizing radiation [ 7 ]. Therefore, it is very important to find new targets suitable for large-scale screening and prevention of urological cancers.…”

Concomitant Immunotherapy and Metastasis-Directed Radiotherapy in Upper Tract Urothelial Carcinoma: A Biomarker-Driven, Original, Case-Based Proof-of-Concept Study

“…Liquid biopsy, a series of techniques aimed at acquiring information about cancer from its circulating by-products (e.g., circulating tumor cells, circulating tumor DNA (ctDNA), cancer-derived extracellular vesicles) could contribute to biomarker detection. Specifically, it has been demonstrated in mUC patients that ctDNA represents a bona fide representation of tissue tumor DNA [58]. Moreover, since ctDNA comes from all active tumor sites, it could offer a better landscape of tumor heterogeneity, potentially overcoming the intrinsic limit of tissue biopsy.…”

Sialylation on vesicular integrin β1 determined endocytic entry of small extracellular vesicles into recipient cells

“…sEV are nano-sized, spherical, bilayer membrane vesicles released by cells into the extracellular microenvironment under both normal and pathological conditions [ 6 ]. Tumor cell-derived sEV package various bioactive ingredients (including proteins, messenger RNAs, and microRNAs) and deliver such cargoes to recipient cells [ 7 – 9 ], and therefore play key roles in angiogenesis [ 10 ], tumor metastasis [ 11 ], and tumor microenvironment remodeling [ 12 , 13 ].…”