Display options
Share it on

Oncotarget. 2018 May 18;9(38):25265-25276. doi: 10.18632/oncotarget.25404. eCollection 2018 May 18.

Quantitative monitoring of circulating tumor DNA predicts response of cutaneous metastatic melanoma to anti-PD1 immunotherapy.

Oncotarget

Guillaume Herbreteau, Audrey Vallée, Anne-Chantal Knol, Sandrine Théoleyre, Gaelle Quéreux, Emilie Varey, Amir Khammari, Brigitte Dréno, Marc G Denis

Affiliations

  1. Laboratoire de Biochimie et Plateforme de Génétique Moléculaire des Cancers, CHU Nantes, Nantes, France.
  2. Centre de Recherche en Cancérologie et Immunologie, CRCINA, INSERM U1232, Nantes, France.
  3. Service de Dermatologie, CHU Nantes, Nantes, France.
  4. Centre d'Investigation Clinique INSERM CIC1413, CHU Nantes, Nantes, France.

PMID: 29861869 PMCID: PMC5982743 DOI: 10.18632/oncotarget.25404

Abstract

Immunotherapies have changed the medical management of metastatic melanoma. However, the early detection of patients who do not respond to these treatments is a key issue. We evaluated the quantitative monitoring of circulating tumor DNA (ctDNA) as an early predictor of response to anti-PD1. Patients treated with anti-PD1 for metastatic mutated melanoma were selected. The somatic alteration detected on the tumor tissue was quantified on plasma DNA by digital PCR (dPCR) at treatment initiation, after 2 and 4 weeks of treatment, and then every 4 weeks until progression. The absence of biological response (defined as a significant decrease in the amount of ctDNA relative to the baseline level) after 2 weeks of treatment was associated with a lack of clinical benefit under anti-PD1. In the presence of a biological response at week 2, detection of subsequent biological progression (significant increase in the amount of ctDNA relative to its nadir) was 100% predictive of progressive disease, on average 75 days prior to radiological detection. Patients with a persistent biological response beyond week 16 did not experience any progressive disease and exhibited sustained responses. In conclusion, we show that quantitative monitoring of ctDNA, using criteria accounting for dPCR measurement imprecision, allows the early and specific detection of patients who do not respond to anti-PD1 therapy.

Keywords: anti-PD1; cell-free DNA; circulating tumor DNA; digital PCR; metastatic melanoma

Conflict of interest statement

CONFLICTS OF INTEREST No potential conflicts of interest were disclosed.

References

  1. J Transl Med. 2016 Apr 19;14 :95 - PubMed
  2. J Clin Oncol. 2018 Feb 1;36(4):383-390 - PubMed
  3. Exp Dermatol. 2016 Oct;25(10 ):783-8 - PubMed
  4. J Clin Invest. 2016 Sep 1;126(9):3447-52 - PubMed
  5. Sci Transl Med. 2015 Aug 26;7(302):302ra133 - PubMed
  6. Cancer Discov. 2016 Aug;6(8):827-37 - PubMed
  7. Nature. 2014 Nov 27;515(7528):568-71 - PubMed
  8. Clin Cancer Res. 2009 Dec 1;15(23 ):7412-20 - PubMed
  9. Clin Cancer Res. 2015 Jul 15;21(14):3196-203 - PubMed
  10. JAMA Oncol. 2018 May 1;4(5):717-721 - PubMed
  11. Lancet Oncol. 2016 Dec;17 (12 ):e542-e551 - PubMed
  12. Ann Oncol. 2017 May 1;28(5):1130-1136 - PubMed
  13. JCI Insight. 2017 Jul 20;2(14 ): - PubMed
  14. Sci Transl Med. 2016 Jul 6;8(346):346ra92 - PubMed
  15. Clin Chem. 2015 Jan;61(1):297-304 - PubMed
  16. Lancet Oncol. 2017 Mar;18(3):e143-e152 - PubMed
  17. N Engl J Med. 2015 Jan 22;372(4):320-30 - PubMed
  18. Lancet Oncol. 2016 Nov;17 (11):1558-1568 - PubMed
  19. N Engl J Med. 2015 Jun 25;372(26):2521-32 - PubMed
  20. Clin Lung Cancer. 2017 Sep;18(5):583-588 - PubMed
  21. Lancet Oncol. 2015 Aug;16(8):908-18 - PubMed
  22. Cancer Discov. 2017 Dec;7(12 ):1394-1403 - PubMed
  23. J Thorac Oncol. 2015 Oct;10(10):1437-43 - PubMed
  24. N Engl J Med. 2015 Jul 2;373(1):23-34 - PubMed
  25. Clin Cancer Res. 2016 Feb 1;22(3):567-74 - PubMed

Publication Types