Data from Circulating Tumor Cells and Early Relapse in Node-positive Melanoma

Abstract

<div>AbstractPurpose:<p>There is a need for sensitive, reproducible biomarkers for patients with stage III melanoma to guide clinical decision making. Circulating tumor cells (CTCs) can be detected in patients with melanoma; however, there are limited data regarding their significance in stage III disease. The aim of this study was to determine whether CTCs are associated with early relapse in stage III melanoma.</p>Experimental Design:<p>We prospectively assessed CTCs at first presentation in clinic (baseline) for 243 patients with stage III melanoma. CTCs were measured using the CellSearch System. Relapse-free survival (RFS) was compared between patients with one or more baseline CTC versus those with no CTCs. Log-rank test and Cox regression analysis were applied to establish associations of CTCs with RFS.</p>Results:<p>At least one baseline CTC was identified in 90 of 243 (37%) patients. Forty-five (19%), 67 (28%), 118 (49%), and 13 (5%) patients were stage IIIA, IIIB, IIIC, or IIID, respectively. CTC detection was not associated with substage, or primary tumor characteristics. Multivariable analysis demonstrated that the detection of ≥1 baseline CTC was significantly associated with decreased 6-month RFS [log-rank, <i>P</i> < 0.0001; HR, 3.62, 95% confidence interval (CI), 1.78–7.36; <i>P</i> < 0.0001] and 54-month RFS (log-rank, <i>P</i> = 0.01; HR, 1.69; 95% CI, 1.13–2.54; <i>P</i> = 0.01).</p>Conclusions:<p>≥1 CTC was independently associated with melanoma relapse, suggesting that CTC assessment may be useful to identify patients at risk for relapse who could derive benefit from adjuvant therapy.</p></div>