Circulating tumour DNA and melanoma survival: A systematic literature review and meta-analysis

Sara Gandini, Ines Zanna, Simone Pietro De Angelis, Emilia Cocorocchio, Paola Queirolo, Jenny H. Lee, Matteo S. Carlino, Luca Mazzarella, Bruno Achutti Duso, Domenico Palli, Sara Raimondi, Saverio Caini

Research output: Contribution to journalReview articlepeer-review


We reviewed and meta-analysed the available evidence (until December 2019) about circulating tumour DNA (ctDNA) levels and melanoma patients survival. We included twenty-six studies (>2000 patients overall), which included mostly stage III-IV cutaneous melanoma patients and differed widely in terms of systemic therapy received and somatic mutations that were searched. Patients with detectable ctDNA before treatment had worse progression-free survival (PFS) (summary hazard ratio (SHR) 2.47, 95 % confidence intervals (CI) 1.85–3.29) and overall survival (OS) (SHR 2.98, 95 % CI 2.26–3.92), with no difference by tumour stage. ctDNA detectability during follow-up was associated with poorer PFS (SHR 4.27, 95 %CI 2.75–6.63) and OS (SHR 3.91, 95 %CI 1.97–7.78); in the latter case, the association was stronger (p = 0.01) for stage IV vs. III melanomas. Between-estimates heterogeneity was low for all pooled estimates. ctDNA is a strong prognostic biomarker for advanced-stage melanoma patients, robust across tumour (e.g. genomic profile) and patients (e.g. systemic therapy) characteristics.

Original languageEnglish
Article number103187
JournalCritical Reviews in Oncology/Hematology
Publication statusPublished - Jan 2021


  • Circulating tumour DNA
  • Melanoma
  • Meta-analysis
  • Review
  • Survival

ASJC Scopus subject areas

  • Hematology
  • Oncology


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