High-risk melanoma: preoperative ctDNA predicts survival in Australian study

  • Lee JH & al.
  • Ann Oncol
  • 12 Mar 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Detectable preoperative circulating tumor (ct)DNA is associated with reduced disease-specific survival (DSS) in patients with stage III cutaneous melanoma.

Why this matters

  • Marker could help stratify patients for adjuvant therapy.

Key results

  • ctDNA was detected in 34% of patients in the discovery cohort and 33% of patients in the validation cohort.
  • ctDNA positivity was associated with larger nodal melanoma deposit (P<.01 increased number of melanoma-involved lymph nodes method detection and high lactose dehydrogenase levels>
  • ctDNA positivity was associated with reduced DSS in the discovery cohort (HR, 1.85; P=.042) and validation cohort (HR, 3.02; P=.025) in multivariate analysis.
  • ctDNA positivity was associated with reduced distant metastasis recurrence-free survival in the validation cohort (HR, 2.55; P=.0085), but not in the discovery cohort (HR 1.38; P=.1593), in multivariate analysis.

Study design

  • 174 patients with stage III melanoma (119 in the discovery cohort, 55 in the validation cohort) who received complete lymph node dissection were analyzed for associations between preoperative ctDNA and outcomes.
  • Funding: National Health and Medical Research Council, CLEARbridge Foundation.

Limitations

  • No analysis of postsurgery ctDNA.

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