Circulating tumor DNA. Modern views about the possibility of use in uveal melanoma

Choroidal melanoma is the most common and highly malignant intraocular tumor due to its tendency to hematogenous metastasis. In the vast majority of cases, the liver is affected. Metastases in uveal melanoma (UM) develop in half of patients on average within 4.4 years after treatment. Currently, single drugs are appearing that can be used for adjuvant therapy of metastatic UM, but these drugs show limited efficacy. Until now, the only radical method of treating metastatic disease in UM is surgical destruction of single metastases in the liver. The review considers the possibility of determining circulating tumor DNA as a highly specific, sensitive, accessible and non-invasive method for diagnosing and monitoring the treatment of oncological diseases. Circulating tumor DNA can be one of the prognostic signs of UM, which helps to form high-risk groups of early metastasis for a personalized approach to the frequency of radiation diagnostic methods and detection of single metastases in the liver. With the emergence of effective methods of systemic drug therapy for metastatic UM, circulating tumor DNA can be used to monitor the effectiveness of treatment. The study of circulating DNA also allows us to determine the mutational features of the primary tumor, which in turn can be used for the differential diagnosis of primary UM and other tumors of the choroid, including metastases of cutaneous melanoma to the choroid. The review considers the possibility of using circulating tumor DNA in UM as a prognostic factor and diagnostic tool, as well as a method for assessing the effectiveness of therapy for metastatic UM.