Detection of clinical progression through plasma ctDNA in metastatic melanoma patients: a comparison to radiological progression.
Br J Cancer
; 126(3): 401-408, 2022 02.
Article
in En
| MEDLINE
| ID: mdl-34373567
ABSTRACT
BACKGROUND:
The validity of circulating tumour DNA (ctDNA) as an indicator of disease progression compared to medical imaging in patients with metastatic melanoma requires detailed evaluation.METHODS:
Here, we carried out a retrospective ctDNA analysis of 108 plasma samples collected at the time of disease progression. We also analysed a validation cohort of 66 metastatic melanoma patients monitored prospectively after response to systemic therapy.RESULTS:
ctDNA was detected in 62% of patients at the time of disease progression. For 67 patients that responded to treatment, the mean ctDNA level at progressive disease was significantly higher than at the time of response (P < 0.0001). However, only 30 of these 67 (45%) patients had a statistically significant increase in ctDNA by Poisson test. A validation cohort of 66 metastatic melanoma patients monitored prospectively indicated a 56% detection rate of ctDNA at progression, with only two cases showing increased ctDNA prior to radiological progression. Finally, a correlation between ctDNA levels and metabolic tumour burden was only observed in treatment naïve patients but not at the time of progression in a subgroup of patients failing BRAF inhibition (N = 15).CONCLUSIONS:
These results highlight the low efficacy of ctDNA to detect disease progression in melanoma when compared mainly to standard positron emission tomography imaging.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Magnetic Resonance Imaging
/
Biomarkers, Tumor
/
Tumor Burden
/
Positron Emission Tomography Computed Tomography
/
Circulating Tumor DNA
/
Melanoma
Type of study:
Diagnostic_studies
/
Observational_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Br J Cancer
Year:
2022
Type:
Article
Affiliation country:
Australia