Circulating Tumor DNA as a Predictor of Recurrence and Survival in Cutaneous Melanoma Treated With Dermatologic Surgery: A Review

BACKGROUND: Circulating tumor DNA (ctDNA) measures cancer-specific genetic material migrated from a tumor to a patient's bloodstream. Limited research exists aggregating data on ctDNA as a measure of recurrence, treatment success, and survival in patients with melanoma. OBJECTIVE: The authors aim to evaluate evidence for ctDNA as a measurement of recurrence and survival, and how those results differ by tumor grade and measurement time point in cutaneous melanoma treated with dermatologic surgery. METHODS: An OVID Medline search and manual filtering resulted in six studies meeting the inclusion criteria: evaluating survival and/or disease recurrence by ctDNA measurement in patients with cutaneous melanoma who had undergone dermatologic surgery. RESULTS: Sequencing methods varied: some studies analyzed known gene mutations and others developed individual tumor assays. Individual assays provide more information but are less practical to perform. Significant relationships between postoperative ctDNA level and disease recurrence and survival were found in multiple studies. The most represented stages of melanoma included were II and III. All studies measured postoperative ctDNA, but at unique time points. CONCLUSION: ctDNA measurement may be a useful tool in measuring treatment efficacy and disease recurrence in patients with cutaneous melanoma treated with dermatologic surgery.