Figure 6.
MutDNA analysis may help stratify patients with MIBC in the future. Based on our data, we have generated a model by which a patient’s outcome can be predicted by mutDNA status before and during NAC. Specifically, mutDNA status may be used to stratify patients into 3 groups. Firstly, patients with undetectable mutDNA pre-NAC and during NAC, have a low (or no) burden of disease (green). Secondly, patients with detected mutDNA pre-NAC but with negative samples at the 2nd NAC cycle are likely to benefit from their NAC and subsequent definitive therapy (yellow). Finally, patients with mutDNA detected before and during NAC are unlikely to benefit from continued NAC and often progress (red). These patients should be considered for expedited definitive treatment or alternative treatments (e.g. targeted therapy or immune checkpoint inhibition).