Author Identifier

Anna Reid

ORCID : 0000-0002-4588-1679

Elin Gray

ORCID : 0000-0002-8613-3570

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

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

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

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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