Ashleigh C. McEvoy, Edith Cowan UniversityFollow
Michelle R. Pereira, Edith Cowan UniversityFollow
Anna Reid, Edith Cowan UniversityFollow
Robert Pearce, Edith Cowan UniversityFollow
Muhammad A. Khattak, Edith Cowan UniversityFollow
Tarek M. Meniawy
Elin S. Gray, Edith Cowan UniversityFollow
Melanie R. Ziman, Edith Cowan UniversityFollow
Impact Journals LLC
School of Medical and Health Sciences
NHMRC Number : 1046711
Background: A significant number of melanoma patients experience recurrence to distant sites, despite having had surgical treatment of the primary lesion, with curative intent. Monitoring of patients for early evidence of disease recurrence would significantly improve management of the disease, allowing timely therapeutic intervention. Circulating tumor DNA (ctDNA) is becoming a well-recognized biomarker for monitoring malignancies and has, in a few studies, been shown to signify disease recurrence earlier than conventional methods.
Methods: We performed a retrospective analysis of plasma ctDNA using droplet digital PCR (ddPCR) in 30 primary melanoma patients with tumors harboring BRAF, NRAS or TERT promoter mutations. Mutant specific ctDNA, measured during clinical disease course, was compared with disease status in patients with confirmed disease recurrence (n = 3) and in those with no evidence of disease recurrence (n = 27).
Results: Mutant specific ctDNA was detected in all three patients with disease recurrence at the time of clinically confirmed progression. In one case, plasma ctDNA detection preceded clinical identification of recurrence by an interval of 4 months. CtDNA was not detected in patients who were asymptomatic and had no radiological evidence of recurrence.
Conclusions: This study demonstrates promising results for the use of ctDNA as an informative monitoring tool for melanoma patients having undergone tumor resection of an early stage primary tumor. The clinical utility of ctDNA for monitoring disease recurrence warrants investigation in prospective studies as it may improve patient outcome.
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