New MRV Research: Researchers at Peter Mac have developed a simple liquid biopsy test……

Researchers at Peter Mac have developed a simple liquid biopsy test that can predict and monitor melanoma relapse following surgery.

The study, led by Dr. Lavinia Tan, Dr Stephen Wong, Dr. Shahneen Sandhu and Professor Sarah-Jane Dawson, looked at stage III melanoma patients recruited to the Melanoma Research Victoria (MRV) cohort study, and involved a collaboration with Professor Richard Marias and Dr. Rebecca Lee from the Cancer Research UK Manchester Institute, Manchester, UK.

More than 40% of stage III melanoma patients treated with surgery will relapse within 5 years. While patients can receive adjuvant treatment (such as immunotherapy or targeted therapy) that can significantly decrease the risk of melanoma returning, there are currently no tests that can predict which patients are at highest risk of relapse, to guide the delivery of adjuvant therapy to those most likely to benefit and avoid the toxicity of treatment in patients cured with surgery alone.

The study, published in Annals of Oncology, showed that the detection of small fragments of tumour DNA in a patient’s blood (called circulating tumour DNA (ctDNA)), after a tumour has been surgically removed, was associated with a high risk of melanoma relapse. Serial analysis of ctDNA also allowed real-time monitoring of disease recurrence with ctDNA detection preceding clinical relapse in 50% of the cases studied.

Whilst the study represents an initial proof of concept, the findings highlight the promising potential of ctDNA analysis to guide the frequency of radiological imaging surveillance and direct the delivery of adjuvant therapy. The incorporation of ctDNA analysis into several large clinical trials is currently underway to establish the clinical utility of this approach to inform adjuvant therapy decisions.

The research was supported by the Australian National Health and Medical Research Council, Cancer Research UK and the Wellcome Trust.

Link to paper: L Tan, S Sandhu, R J Lee, J Li, J Callahan, S Ftouni, N Dhomen, P Middlehurst, A Wallace, J Raleigh, A Hatzimihalis, M A Henderson, M Shackleton, A Haydon, V Mar, D E Gyorki, D Oudit, M A Dawson, R J Hicks, P Lorigan, G A McArthur, R Marais, S Q Wong, S -J Dawson; Prediction and monitoring of relapse in stage III melanoma using circulating tumor DNA, Annals of Oncology,

mdz048, https://doi.org/10.1093/annonc/mdz048

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