A Liquid Biopsy in Bladder Cancer-The Current Landscape in Urinary Biomarkers

Abstract

The non-muscle invasive bladder cancer tends to recur and progress. Therefore, it requires frequent follow-ups, generating costs and making it one of the most expensive neoplasms. Considering the expensive and invasive character of the current gold-standard diagnostic procedure, white-light cystoscopy, efforts to find an alternative method are ongoing. Although the last decade has seen significant advancements in urinary biomarker tests (UBTs) for bladder cancer, international guidelines have not recommended them. Currently, the paramount urgency is to find and validate the test with the best specificity and sensitivity, which would allow for the optimizing of diagnosis, prognosis, and a treatment plan. This review aims to summarise the up-to-date state of knowledge relating to UBTs and new developments in the detection, prognosis, and surveillance of bladder cancer and their potential applications in clinical practice.

Keywords: biological fluids; bladder cancer; cancer biomarkers; cell-free DNA; cfDNA; diagnosis; exosomes; extracellular vesicles; liquid biopsy; personalized therapy; precision oncology; prognosis; tumour markers.

Figure 1

Bladder cancer staging. When the tumour invades the detrusor muscle or beyond (T2-T4 stage), then it is called the muscle-invasive type (MIBC) [4].