Detection of clinical progression through plasma ctDNA in metastatic melanoma patients: a comparison to radiological progression

Author:

Marsavela Gabriela,McEvoy Ashleigh C.,Pereira Michelle R.,Reid Anna L.,Al-Ogaili Zeyad,Warburton Lydia,Khattak Muhammad A.,Abed Afaf,Meniawy Tarek M.,Millward Michael,Ziman Melanie R.,Calapre Leslie,Gray Elin S.ORCID

Abstract

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.

Funder

Western Australia Health Translational Network

Publisher

Springer Science and Business Media LLC

Subject

Cancer Research,Oncology

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