Biomarker Monitoring for Personalized Treatment of Patients With Advanced Melanoma
Posted: Monday, December 10, 2018
A summative review of recent advances in the understanding of biomarkers, published in Cancer Treatment Reviews, suggests the emergence of the potential for personalized treatment for patients with advanced melanoma. Ahmad Tarhini, MD, PhD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues evaluated existing research on predictive factors and on-treatment monitoring of biomarkers in this patient population.
“Emerging technological advances combined with a growing knowledge of tumor biology present the opportunity to evaluate on-treatment markers that could help to predict outcomes, provide an early indication of response or progression, and aid in the understanding of therapeutic resistance,” stated the authors. “Research in biomarkers is a rapidly evolving field that is destined to change the way we care for melanoma patients in the near future.”
The study finds BRAF V600 mutation to be the only currently validated predictive marker for patients with melanoma, but evidence was reported for the potential for others. For example, the mutation or deletion of CDKN2A in patients treated with dabrafenib and trametinib is associated with decreased survival outcomes. Furthermore, certain characteristics of a tumor or its microenvironment that can alter the effectiveness of immune checkpoint inhibitor therapies have also been identified as potential predictive markers.
In addition to markers predictive of treatment outcomes, ongoing biomarker monitoring during therapy may provide early information on response to treatment as well as mechanisms of acquired resistance. An example of on-treatment monitoring is the use of liquid biopsies, which may help determine response, resistance, and toxicity. The authors noted that this procedure, along with many other tools to monitor biomarkers in patients with melanoma, are in their infancy and require further validation before being suitable for widespread adoption.