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Posted by on Apr 13, 2019 in Melanoma | 0 comments

In a nutshell

This study investigated the use of circulating tumor DNA (ctDNA) to predict treatment response in advanced melanoma. 

They found that ctDNA levels can predict survival in these patients.

Some background

Melanoma is categorized, like many cancers, in stages. At stage 3 and above, survival rates can vary depending on treatment.

Identifying a biomarker may predict the chance of survival in advanced melanoma. A biomarker is a gene, protein or chemical that can be identified in a blood or tissue sample. If the level of a biomarker changes relative to other indicators, e.g. survival, then it can be used to predict the success of treatment. This is particularly important for new drugs. Immune-checkpoint inhibitors (ICIs) are a new type of cancer drug. They are expensive and have some side effects. Predicting the response to treatment is important in advanced cancer. 

Methods & findings

This study included 174 patients with stage 3 skin melanoma. Blood samples were taken before surgery and processed for biomarkers. The investigators analyzed tumor DNA circulating in the blood (ctDNA). Patients were followed up for an average of 26 months.

ctDNA was found in 33-34% of patients. ctDNA levels were higher in patients with worse disease and larger tumors. Survival with melanoma was 17.6- 23.9 months in patients with average ctDNA levels. This was compared to 49.4- 92.1 months in patients with undetectable ctDNA. The risk of death was 2.11-2.29-times higher in patients with the average detected ctDNA.

The bottom line

The authors concluded that ctDNA levels can predict survival in patients with melanoma undergoing surgery. They suggested that this biomarker may help identify patients that would benefit from treatment after surgery.

The fine print

Measuring ctDNA before surgery to remove the tumor appears to predict survival. ctDNA levels were not measured after surgery. This may be important in predicting outcomes also. More investigation is needed. 

Published By :

Annals of oncology: official journal of the European Society for Medical Oncology

Date :

Mar 12, 2019

Original Title :

Pre-operative ctDNA predicts survival in high-risk stage III cutaneous melanoma patients.

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