The role of “Liquid Biopsy” in the management of genitourinary malignancies

A liquid biopsy is a specimen from blood, urine, saliva or other body fluids tested as a marker for cancer.  Examples include circulating DNA, cell-free DNA, and other biomarkers that are from normal cells or cancer cells that can be accurately measured.  Liquid biopsies have several advantages and disadvantages over standard tissue biopsy methods.  Prognostic biomarkers help identify patients at higher risk for cancer and may guide treatment selection or appropriate monitoring intensity.  Liquid biopsies have shown promise in several clinical practice applications but have been relatively understudied and underutilized in genitourinary cancers.  Benjamin L. Maughan and colleagues reviewed the medical literature on this topic and summarized the current knowledge relevant to prostate, kidney, urothelial, and testicular cancers.  The utilization of liquid biopsies will likely increase as new biomarkers are discovered and validated.  Current areas of utility include patient selection for adjuvant therapy in kidney and urothelial cancer, screening of high-risk populations, and new predictive testing of systemic therapy.  Each application will require validation to contribute to personalized care and improved patient outcomes.

Eur Urol 88:2025;449-461.