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Soo Park, MD
Soo Park, MD
Posted: Monday, November 25, 2024
Jorge E. Arpi Palacios, MD, of the Cleveland Clinic, and colleagues developed a circulating tumor DNA (ctDNA) next-generation sequencing panel to quantify circulating melanoma genes in patients with resected high-risk stage III disease. Their findings were presented during the 2024 Society for Immunotherapy of Cancer (SITC) Annual Meeting (Abstract 618).
“Despite improved outcomes for resectable advanced melanoma with effective systemic therapy, there are no good biomarkers currently to predict response to adjuvant therapy,” the investigators commented. “ctDNA is an emerging biomarker in melanoma.”
After undergoing surgery (wide excision with sentinel lymph node biopsy: 72.0%; wide excision with lymph node dissection: 11.6%; lymph node dissection alone: 16.2%), a total of 43 patients provided blood samples at baseline, 3 months, 6 months, and 18 months. An additional sample was collected from those who developed a clinical recurrence. A total of 36 patients underwent active adjuvant therapy with an anti–PD-1 immune checkpoint inhibitor (82.9%) or combined targeted regimen (17.0%). Follow-up data were provided for a median of 38 months.
Biopsy-confirmed recurrences were documented in 13 patients (30.2%). The median time to recurrence was 14.5 months. At baseline, ctDNA was positive in 39 patients (90.6%); nearly one-third of this population (n = 12; 30.7%) developed recurrence. Four patients (8.3%) tested negative for ctDNA at baseline, of whom one experienced a subsequent recurrence. Of note, the number of somatic mutations was found to progressively increase in absolute quantity in all ctDNA-positive patients who developed recurrence.
“Additional study is needed to develop algorithms to help predict recurrence or help early ascertainment of relapse to guide treatment and follow-up for patients,” the investigators concluded. “Further studies are needed to determine specificity and sensitivity of this diagnostic to guide use in the treatment of melanoma.”
Disclosure: No information regarding conflicts of interest was provided.
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