Document Type
Journal Article
Publication Title
British Journal of Cancer
Volume
126
Publisher
Springer Nature
School
School of Medical and Health Sciences / Centre for Precision Health
RAS ID
38863
Funders
Edith Cowan University - Open Access Support Scheme 2021
National Health and Medical Research Council,
Cancer Council WA,
Department of Health Western Australia,
Spinnaker Foundation,
Perpetual Foundation,
Western Australia Health Translational Network,
Edith Cowan University
Grant Number
NHMRC Number : 1117911, 1190643
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.
DOI
10.1038/s41416-021-01507-6
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Marsavela, G., McEvoy, A. C., Pereira, M. R., Reid, A. L., Al-Ogaili, Z., Warburton, L., . . . Gray, E. S. (2022). Detection of clinical progression through plasma ctDNA in metastatic melanoma patients: A comparison to radiological progression. British Journal of Cancer, 126, p. 401-408.
https://doi.org/10.1038/s41416-021-01507-6