Gregory Daniels, MD, PhD, associate clinical professor of medicine, hematology-oncology, Moores Cancer Center, University of California San Diego, discusses emerging strategies to monitor patients at high risk for melanoma recurrence.
“Monitoring for patients is advancing,” he said. “We’re going to be better able to risk-stratify patients … as well as add technique.”
Offering background on the populations somewhat “arbitrarily” defined by guidelines as having elevated risk and a review of the “limited” nature of tests and information traditionally used for early detection, Daniels details the movement toward improved surveillance.
He points to molecular profiling as a means to better gauge risk, differentiating between invasive and non-invasive means.
Daniels highlights the use of transcription patterns as “a very exciting approach” to stratify patients, outlining the clinical characteristics and divisions in the test marketed today and how physicians can use that information.
He goes on to describe strategies focused on blood as a predictor, which use circulating-free, cell-free or high molecular weight DNA as “clues” to the presence of melanoma presence.
“Looking at DNA fractions in the blood, it appears we can pre-date any symptom-change, or any change that we can see on imaging in a routine sense, in patients who will go on to develop recurrent disease.”
He notes the approach is still in the validation phase, with the field working to determine the best technology to use, the target populations for application and the appropriate response.