The prognostic value of circulating tumor DNA in malignant melanoma patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis
BackgroundCirculating tumor DNA (ctDNA) is an emerging biomarker in malignant melanoma(MM), and high levels of ctDNA may reflect a higher tumor load. However, its prognostic value for MM receiving immune checkpoint inhibitors(ICI) remains controversial. This meta-analysis aimed to elucidate the prog...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1520441/full |
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| author | Lei Liu Shufu Hou Aiping Zhu Bing Yan Linchuan Li Dandan Song |
| author_facet | Lei Liu Shufu Hou Aiping Zhu Bing Yan Linchuan Li Dandan Song |
| author_sort | Lei Liu |
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| description | BackgroundCirculating tumor DNA (ctDNA) is an emerging biomarker in malignant melanoma(MM), and high levels of ctDNA may reflect a higher tumor load. However, its prognostic value for MM receiving immune checkpoint inhibitors(ICI) remains controversial. This meta-analysis aimed to elucidate the prognostic significance of ctDNA in this patient population.MethodsWe conducted a comprehensive search of the PubMed, Cochrane Library, CNKI, and EMBASE databases, including studies published up to August 15, 2024, to investigate the prognostic impact of ctDNA in MM patients treated with ICI. Using a fixed-effects model, we systematically evaluated the association between ctDNA levels and key survival outcomes, including overall survival (OS) and progression-free survival (PFS). Additionally, funnel plots, Begg’s test, and Egger’s test were employed to assess potential publication bias.ResultsTwelve studies from eleven articles, involving a total of 1063 eligible MM patients receiving ICI therapy, were included. The results indicated that patients with detectable ctDNA before initiating ICI therapy had significantly poorer OS (HR = 3.19, 95% CI = 2.22–4.58, P < 0.001) and PFS (HR = 2.08, 95% CI = 1.61–2.69, P < 0.001). Furthermore, the detectability of ctDNA during treatment was also significantly associated with worse OS (HR = 4.57, 95% CI = 3.03–6.91, P < 0.001) and PFS (HR = 3.79, 95% CI = 2.13–6.75, P < 0.001).ConclusionsThis meta-analysis indicates that in MM patients receiving ICI therapy, detectable and high levels of ctDNA are significantly associated with poorer OS and PFS. Therefore, ctDNA can serve as a diagnostic and stratification tool prior to treatment, as well as an effective indicator for monitoring treatment response and disease progression.Systematic Review Registrationwww.inplasy.com, identifier INPLASY2024110018. |
| format | Article |
| id | doaj-art-028b79a7c5eb48e6a5248e844b236eb2 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj-art-028b79a7c5eb48e6a5248e844b236eb22025-02-06T07:37:15ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.15204411520441The prognostic value of circulating tumor DNA in malignant melanoma patients treated with immune checkpoint inhibitors: a systematic review and meta-analysisLei Liu0Shufu Hou1Aiping Zhu2Bing Yan3Linchuan Li4Dandan Song5Department of Neurology, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Neurology, Shandong Second Provincial General Hospital, Jinan, ChinaDepartment of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan, ChinaDepartment of Neurology, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, ChinaBackgroundCirculating tumor DNA (ctDNA) is an emerging biomarker in malignant melanoma(MM), and high levels of ctDNA may reflect a higher tumor load. However, its prognostic value for MM receiving immune checkpoint inhibitors(ICI) remains controversial. This meta-analysis aimed to elucidate the prognostic significance of ctDNA in this patient population.MethodsWe conducted a comprehensive search of the PubMed, Cochrane Library, CNKI, and EMBASE databases, including studies published up to August 15, 2024, to investigate the prognostic impact of ctDNA in MM patients treated with ICI. Using a fixed-effects model, we systematically evaluated the association between ctDNA levels and key survival outcomes, including overall survival (OS) and progression-free survival (PFS). Additionally, funnel plots, Begg’s test, and Egger’s test were employed to assess potential publication bias.ResultsTwelve studies from eleven articles, involving a total of 1063 eligible MM patients receiving ICI therapy, were included. The results indicated that patients with detectable ctDNA before initiating ICI therapy had significantly poorer OS (HR = 3.19, 95% CI = 2.22–4.58, P < 0.001) and PFS (HR = 2.08, 95% CI = 1.61–2.69, P < 0.001). Furthermore, the detectability of ctDNA during treatment was also significantly associated with worse OS (HR = 4.57, 95% CI = 3.03–6.91, P < 0.001) and PFS (HR = 3.79, 95% CI = 2.13–6.75, P < 0.001).ConclusionsThis meta-analysis indicates that in MM patients receiving ICI therapy, detectable and high levels of ctDNA are significantly associated with poorer OS and PFS. Therefore, ctDNA can serve as a diagnostic and stratification tool prior to treatment, as well as an effective indicator for monitoring treatment response and disease progression.Systematic Review Registrationwww.inplasy.com, identifier INPLASY2024110018.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1520441/fullcirculating tumor DNAimmune checkpoint inhibitorsmalignant melanomaoverall survivalprogression-free survival |
| spellingShingle | Lei Liu Shufu Hou Aiping Zhu Bing Yan Linchuan Li Dandan Song The prognostic value of circulating tumor DNA in malignant melanoma patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis Frontiers in Immunology circulating tumor DNA immune checkpoint inhibitors malignant melanoma overall survival progression-free survival |
| title | The prognostic value of circulating tumor DNA in malignant melanoma patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis |
| title_full | The prognostic value of circulating tumor DNA in malignant melanoma patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis |
| title_fullStr | The prognostic value of circulating tumor DNA in malignant melanoma patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis |
| title_full_unstemmed | The prognostic value of circulating tumor DNA in malignant melanoma patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis |
| title_short | The prognostic value of circulating tumor DNA in malignant melanoma patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis |
| title_sort | prognostic value of circulating tumor dna in malignant melanoma patients treated with immune checkpoint inhibitors a systematic review and meta analysis |
| topic | circulating tumor DNA immune checkpoint inhibitors malignant melanoma overall survival progression-free survival |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1520441/full |
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