Liquid biopsies have the potential to shape the landscape of bladder cancer care, while lowering the cost of treatment for patients. However, there are still unanswered questions as clinicians await data that is validated in larger cohorts, explained Cristina Magi-Galluzzi, MD, PhD, division director of atomic pathology at the University of Alabama at Birmingham School of Medicine. 

I think some of the challenges are related to the fact that there's a lot viability on the types of techniques that can be used. Of course moving forward, the presence of next-generation sequencing and other new tools that are available would make things probably much more likely to be implemented in clinical practice, but we also need to do more studies to make sure that some of the preliminary data that has been presented across the board can be validated in different cohorts, and not just in small cohorts. 

The value would be, of course, from a patient side, that they are not aggressive. Maybe some of the tests can be done, for example, in urine or in saliva or just in a blood test. They don't need to be biopsied. Particularly for bladder cancer patients, this is important because this will reduce the cost of treating patients with bladder cancer. So there is a lot of expectations, and I think we're [moving] toward the right direction, aiming toward the right direction, but I don't think we are ready yet, just because we need to have a better validation of some of those tests. 

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Liquid biopsies and other novel techniques have the potential to change the bladder cancer space. However, unanswered questions remain.

Cristina Magi-Galluzzi, MD, PhD

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Challenges and Hopes for Liquid Biopsies in Bladder Cancer