ST. PAUL, Minn., April 15 (UPI) — Researchers at New York University (NYU) have developed a gene-based blood test that accurately predicts the likelihood of cancer recurrence in some stage III melanoma patients. The findings, published in The Lancet Oncology on Tuesday, highlight how this test can help identify patients most at risk after undergoing lymph node surgery.
Stage III melanoma is an advanced form of skin cancer where the cancer has spread to nearby lymph nodes or surrounding tissue. Treatment often involves surgery, immunotherapy, or targeted therapy to prevent further progression.
The new test detects a specific type of DNA released by tumors in patients with stage III melanoma. For patients with BRAF gene mutations — who represent around 50% of all melanoma patients — the test proved to be highly effective. Researchers analyzed blood plasma samples and found that 80% of those with detectable circulating tumor DNA (ctDNA) in their blood eventually experienced a recurrence of their cancer.
This research, funded by Novartis, the pharmaceutical company behind melanoma drugs Tafinlar and Mekinist, opens the door for oncologists to better predict which patients will benefit from additional therapies after surgery.
Dr. David Polsky, a dermatologic oncology expert at NYU, emphasized that ctDNA measurements taken within 12 weeks of surgery could significantly improve patient care. “Patients would have a direct measure of the disease itself, unlike current methods that only suggest the likelihood of recurrence,” said Polsky.
The test is particularly useful for melanoma patients who have undergone successful lymph node resections but might skip follow-up therapies due to financial or other personal reasons. The ctDNA test could help identify patients at higher risk, ensuring they receive timely adjuvant therapy.
In some cases, patients who had completed their treatment and later stopped it were found to have detectable ctDNA three months after stopping. This suggests that the test could also assist patients in identifying recurrences if they decide to discontinue therapy.
Although the ctDNA test did not detect cancer in all patients, it showed a strong correlation between a positive result and cancer recurrence, visible on radiographic scans. If further studies confirm these results, the test could become a routine part of melanoma care.
For those with a positive ctDNA result, doctors could take proactive steps, such as ordering earlier CT scans or using more sensitive imaging techniques like PET-CT scans.
Dr. Alastair Greystoke, an oncologist from the Northern Center for Cancer Care in England, praised the study for its cost-effectiveness and robustness. He noted that the test is particularly useful for patients who are at high risk of recurrence but do not require expensive and side-effect-prone treatments unless necessary.
Dr. Marc Hurlbert, CEO of the Melanoma Research Alliance, also welcomed the results, calling ctDNA monitoring a promising tool in melanoma treatment. He highlighted its potential to guide treatment decisions, such as determining when to escalate or de-escalate therapy, or when to transition to clinical trials.
Overall, the increasing use of ctDNA could revolutionize melanoma care by providing a more accurate and accessible way to monitor and treat this aggressive cancer.
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