Prognostic role of early ctDNA dynamics in advanced melanoma patients treated with immune checkpoint inhibitors: real-world data

Circulating tumor DNA (ctDNA) monitoring in predicting treatment response and survival outcomes in solid tumors has shown promising results. A real-world multicenter study in the USA assessed the role of early ctDNA changes, measured 3-4 weeks after initiating immune checkpoint inhibitor (ICI) therapy, in predicting clinical outcomes of patients with unresectable stage III-IV melanoma. One hundred seventeen patients were evaluated. Regression analysis revealed that a decrease in ctDNA between baseline and 3-4 weeks ICI treatment was associated with increased odds of disease control (OR 30.56; p<0.001) and objective response (OR 23.54; p<0.001). Patients with a decrease in ctDNA had increased progression-free survival and overall survival probability (HR 0.18; p<0.001 and HR 0.28; p<0.001, respectively). The authors conclude that monitoring of early ctDNA dynamics in patients with advanced-stage melanoma appears to be a candidate strategy to predict treatment response, risk of progression, and long-term survival.