Pre-operative ctDNA predicts survival in high-risk stage III cutaneous melanoma patients.

Pre-operative ctDNA predicts survival in high-risk stage III cutaneous melanoma patients.

Publication date: Mar 12, 2019

The outcomes of patients with stage III cutaneous melanoma who undergo complete surgical resection can be highly variable, and estimation of individual risk of disease relapse and mortality remains imprecise. With recent demonstrations of effective adjuvant targeted and immune checkpoint inhibitor therapy, more precise stratification of patients for costly and potentially toxic adjuvant therapy is needed. We report the utility of pre-operative circulating tumour DNA (ctDNA) in patients with high-risk stage III melanoma.

ctDNA was analysed in blood specimens that were collected pre-operatively from 174 patients with stage III melanoma undergoing complete lymph node dissection. Cox regression analyses were used to evaluate the prognostic significance of ctDNA for distant metastasis recurrence free survival (DM-RFS) and melanoma specific survival (MSS).

The detection of ctDNA in the discovery and validation cohort was 34% and 33% respectively, and was associated with larger nodal melanoma deposit, higher number of melanoma involved LNs, more advanced stage and high lactose dehydrogenase (LDH) levels. Detectable ctDNA was significantly associated with worse MSS in the discovery (hazard ratio (HR) 2.11 p 

Lee, J.H., Saw, R.P., Thompson, J.F., Lo, S., Spillane, A.J., Shannon, K.F., Stretch, J., Howle, J., Menzies, A.M., Carlino, Kefford, R.F., Long, G.V., Scolyer, R.A., and Rizos, H. Pre-operative ctDNA predicts survival in high-risk stage III cutaneous melanoma patients. 21941. 2019 Ann Oncol.

Concepts Keywords
Adjuvant Adjuvant therapy
Adjuvant Therapy Circulating tumor DNA
Blood RTT
Cohort Cancer
Cox Regression DNA
DM Melanoma
Immune Checkpoint Inhibitor Health
Lactose Clinical medicine
LDH Medicine
Lymph Node Dissection Adjuvant therapy
Melanoma Tumor melanoma
Metastasis III melanoma
Mortality Tumour
Relapse III cutaneous melanoma
Stratification Cutaneous melanoma
Surgical Resection
Tumour

Semantics

Type Source Name
disease MESH tumor
drug DRUGBANK Lactose
gene UNIPROT NODAL
gene UNIPROT SIL1
disease MESH metastasis
gene UNIPROT COX5A
gene UNIPROT COX8A
gene UNIPROT CPOX
pathway BSID Melanoma
disease DOID melanoma
disease MESH melanoma
disease MESH relapse
disease DOID cutaneous melanoma

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