Prognostic significance of circulating tumor DNA in urothelial carcinoma patients undergoing immune checkpoint inhibitor therapy: a systematic review and meta-analysis

作者：Qingping Ma, Shufu Hou, Haibo Ma, Jing Gao, Dandan Song · 发表于：Frontiers in Immunology · 年份：2025 · DOI：10.3389/fimmu.2025.1574449 · 被引用次数：5 · 研究领域：Cancer Genomics and Diagnostics、Bladder and Urothelial Cancer Treatments、Cancer Cells and Metastasis

Background: Circulating tumor DNA (ctDNA) has emerged as a novel biomarker with the advantages of being non-invasive and enabling dynamic monitoring, providing significant clinical insights into the prognosis and management of malignancies. However, its prognostic role in patients with urothelial carcinoma (UC) receiving immune checkpoint inhibitors (ICI) remains controversial. This study aims to systematically review and perform a meta-analysis to evaluate the prognostic significance of ctDNA levels in this specific patient population. Methods: We conducted a comprehensive search of the PubMed, Cochrane Library, CNKI, and EMBASE databases to include studies published up to November 14, 2024, assessing the prognostic value of ctDNA in UC patients treated with ICI. Fixed-effects or random-effects models were used to evaluate the association between ctDNA levels and overall survival (OS), progression-free survival (PFS)/disease-free survival (DFS). Funnel plots, Begg's test, and Egger's test were employed to assess publication bias. Results: Nine studies from eight articles, comprising a total of 862 urothelial carcinoma (UC) patients treated with immune checkpoint inhibitors (ICIs), were included in this meta-analysis. Seven studies investigated the association between baseline circulating tumor DNA (ctDNA) status and clinical outcomes. Compared to patients without detectable ctDNA, those with elevated baseline ctDNA levels exhibited significantly shorter progression-free surv...