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Circulating Tumour DNA Predicts Survival in High-Risk Resected Melanoma Patients
Patients with high-risk stage II/III resected melanoma commonly develop distant metastases. At present, it is impossible to differentiate between patients who will recur or those who are cured by surgery. A new study has investigated if circulating tumour DNA can predict relapse and survival in patients with resected melanoma.
Researchers carried out droplet digital polymerase chain reaction to detect BRAF and NRAS mutations in plasma taken after surgery from 161 stage II/III high-risk melanoma patients enrolled in the AVAST-M adjuvant trial.
Mutant BRAF or NRAS circulating tumour DNA was detected in 15 out of 132 (11 per cent) BRAF mutant patient samples and four out of 29 (14 per cent) NRAS mutant patient samples.
Patients with detectable circulating tumour DNA had a decreased disease-free interval and distant metastasis-free interval versus those with undetectable circulating tumour DNA. Detectable circulating tumour DNA remained a significant predictor after adjustment for performance status and disease stage.
The five-year overall survival rate for patients with detectable circulating tumour DNA was 33 per cent versus 65 per cent for those with undetectable circulating tumour DNA. Overall survival was significantly worse for patients with detectable circulating tumour DNA and remained significant after adjustment for performance status.
The findings of the study indicate that circulating tumour DNA predicts for relapse and survival in high-risk resected melanoma and could aid selection of patients for adjuvant therapy.
Lee, R. J. et al. Circulating tumor DNA predicts survival in patients with resected high-risk stage II/III melanoma. Annals of Oncology. Volume 29. Issue 2. 1 February 2018. Pages 490–496. DOI: https://doi.org/10.1093/annonc/mdx717