Ashish Kamat hosts Alexander Wyatt to discuss the role of circulating tumor DNA (ctDNA) in the clinical management of urothelial carcinoma, especially in metastatic cases. Dr. Wyatt highlights ctDNA's utility in cancer screening, residual disease detection, and therapy monitoring. Data indicates that higher levels of ctDNA often correlate with worse disease prognosis. The conversation also explores limitations, such as ctDNA's inability to detect certain somatic alterations and the need for technological advancements to overcome this. Dr. Wyatt addresses emerging areas of research, like DNA repair gene alterations and epigenomics, and outlines key questions to bolster clinical confidence in ctDNA, including its heterogeneity and evolution during treatment. He anticipates advancements in liquid biopsy techniques, extending to epigenomic and transcriptomic data.

Biographies:

Alexander Wyatt, DPhil, PhD, BSc, Assistant Professor, Department of Urologic Sciences, University of British Columbia, Senior Research Scientist, Vancouver Prostate Centre

Ashish Kamat, MD, MBBS, Professor, Department of Urology, Division of Surgery, University of Texas MD Anderson Cancer Center, President, International Bladder Cancer Group (IBCG), Houston, Texas