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.
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