Circulating tumor cell assays may have a role in the management of bladder cancer, according to a study published in The Journal of Urology.

Ajjai Alva, M.D., from the University of Michigan in Ann Arbor, and colleagues explored the diagnostic use of circulating tumor cells in patients with neoadjuvant bladder cancer.

Twenty patients who were eligible for cisplatin-based neoadjuvant chemotherapy were enrolled in the study and underwent blood draws at baseline and after one chemotherapy cycle. For comparison, 11 patients with metastatic bladder cancer and 13 healthy donors were analyzed.

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The researchers found that median circulating tumor cell counts were 13 at baseline, and 5, 29, and 2 in the neoadjuvant group, metastatic group, and healthy group, respectively, at follow-up.

The concordance of circulating tumor cell levels was 100 percent across replicate tubes. Ten or more circulating tumor cells were seen in four of nine samples with the IsoFlux Test and in none of the same nine samples with CellSearch.

All three patients with medium/high circulating tumor cell levels at baseline and follow-up had unfavorable pathological stage disease at cystectomy four months after baseline.

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In four of eight patients, next generation sequencing analysis showed somatic variant detection using a targeted cancer panel. All eight cases had a medium/high circulating tumor cell level.

“This study demonstrates a potential role for circulating tumor cell assays in the management of bladder cancer,” the authors write.

Several authors disclosed financial ties to Fluxion Biosciences.


  1. Alva A, Friedlander T, Clark M, et al. Circulating Tumor Cells as Potential Biomarkers in Bladder Cancer. The Journal of Urology. 2015. DOI: