Circulating tumour cell liquid biopsy in selecting therapy for recurrent cutaneous melanoma with locoregional pelvic metastases: a pilot study

BMC Res Notes. 2020 Mar 24;13(1):176. doi: 10.1186/s13104-020-05021-5.


Objectives: Circulating tumour cells (CTCs) from liquid biopsies provide an exceptional opportunity to obtain real-time tumour information and are under current investigation in several cancers, including cutaneous melanoma, but face significant drawbacks in terms of non-standardised methodology, low viable cell numbers and accuracy of CTC identification. In this pilot study, we report that chemosensitivity assays using liquid biopsy-derived metastatic melanoma (MM) CTCs, from 7 patients with stage IIIC, BRAF wild-type metastatic melanomas, localized exclusively to the pelvic region, un-eligible for immunotherapy and treated with melphalan hypoxic pelvic perfusion (HPP), is both feasible and useful in predicting response to therapy. Viable MM CTCs (> 5 cells/ml for all 7 blood samples), enriched by transient culture, were characterised in flow cytometry-based Annexin V-PE assays for chemosensitivity to several drugs.

Results: Using melphalan as a standard, chemosensitivity cut-off values of > 60% cell death, were predictive of patient RECIST 1.1 response to melphalan HPP therapy, associated with calculated 100% sensitivity, 66.67% specificity, 33.33% positive predictive, 100% negative predictive, and 71.43% accuracy values. We propose that the methodology in this study is both feasible and has potential value in predicting response to therapy, setting the stage for a larger study. Trial registration Clinical Identifier NCT01920516; date of trial registration: August 6, 2013.

Keywords: Circulating tumour cells; Hypoxic pelvic perfusion; Liquid biopsies; Melphalan; Pelvic loco-regional metastases; Precision oncotherapy; Recurrent melanoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Humans
  • Liquid Biopsy
  • Melanoma / therapy*
  • Middle Aged
  • Neoplasm Recurrence, Local / therapy*
  • Neoplasm Staging
  • Neoplastic Cells, Circulating / pathology*
  • Pelvic Neoplasms / secondary*
  • Pelvic Neoplasms / therapy*
  • Pilot Projects
  • Skin Neoplasms / therapy*

Supplementary concepts

  • Melanoma, Cutaneous Malignant

Associated data