• Pascale Mariani, François-Clément Bidard, Aurore Rampanou, Alexandre Houy, Vincent Servois, Toulsie Ramtohul, Gaelle Pierron, Marion Chevrier, Benjamin Renouf, Olivier Lantz, Sophie Gardrat, Anne Vincent-Salomon, Sergio Roman-Roman, Manuel Rodrigues, Sophie Piperno-Neumann, Nathalie Cassoux, Marc-Henri Stern, and Shufang Renault.
• Department of Surgical Oncology, Institut Curie, Paris, PSL Research University, Paris, France.
• Ann. Surg. 2023 Oct 1; 278 (4): e827e834e827-e834.

ObjectiveWe report here the results of a prospective study of circulating tumor DNA (ctDNA) detection in patients undergoing uveal melanoma (UM) liver metastases resection (NCT02849145).BackgroundIn UM patients, the liver is the most common and often only site of metastases. Local treatments of liver metastases, such as surgical resection, have a likely benefit in selected patients.MethodsUpon enrollment, metastatic UM patients eligible for curative liver surgery had plasma samples collected before and after surgery. GNAQ / GNA11 mutations were identified in archived tumor tissue and used to quantify ctDNA by droplet digital polymerase chain reaction which was then associated with the patient's surgical outcomes.ResultsForty-seven patients were included. Liver surgery was associated with a major increase of cell-free circulating DNA levels, with a peak 2 days after surgery (∼20-fold). Among 40 evaluable patients, 14 (35%) had detectable ctDNA before surgery, with a median allelic frequency of 1.1%. These patients experienced statistically shorter relapse-free survival (RFS) versus patients with no detectable ctDNA before surgery (median RFS: 5.5 vs 12.2 months; hazard ratio=2.23, 95% CI: 1.06-4.69, P =0.04), and had a numerically shorter overall survival (OS) (median OS: 27.0 vs 42.3 months). ctDNA positivity at postsurgery time points was also associated with RFS and OS.ConclusionsThis study is the first to report ctDNA detection rate and prognostic impact in UM patients eligible for surgical resection of their liver metastases. If confirmed by further studies in this setting, this noninvasive biomarker could inform treatment decisions in UM patients with liver metastases.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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