Can Circulating Biomarkers Improve Melanoma Detection and Monitoring?

by Haroon Ahmad, MD 2025-03-24 00:00

PhysicianMedical

🔍 Key Finding

Circulating biomarkers, including circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), microRNA (miRNA), and extracellular vesicles (EVs), show promise for early melanoma detection, monitoring treatment response, and predicting disease progression, but face challenges in sensitivity and standardization.

🔬 Methodology Overview

Design: Mini-review summarizing current research on circulating biomarkers for melanoma.
Focus: CTCs, ctDNA, miRNA, and EVs as potential biomarkers.
Data Sources: Review of recent studies and clinical trials.
Patient Demographics: Studies included patients across various stages of melanoma, from early-stage to metastatic disease.

📊 Evidence

CTCs: Detection rates in advanced melanoma patients range from 28% to 87%, with higher CTC counts associated with worse prognosis.
ctDNA: Low or undetectable pre-treatment ctDNA levels correlate with increased progression-free survival (PFS) and overall survival (OS).
miRNA: Panels of miRNAs (e.g., MELmiR-7) can differentiate early-stage melanoma from healthy controls and predict tumor burden.
EVs: Tumor-derived exosomes are 4–20 times higher in melanoma patients compared to healthy controls, even after surgical resection.

💡 Clinical Impact

Circulating biomarkers offer a non-invasive method for real-time monitoring of melanoma, potentially improving early detection, personalized treatment, and prognosis. They could be particularly valuable in rural and regional settings with limited access to advanced imaging.

🤔 Limitations

CTCs: Low sensitivity in early-stage melanoma and lack of standardized detection methods.
ctDNA: Often undetectable in early-stage disease, requires specialized sample handling, and lacks established cut-off values.
miRNA: Inconsistent expression across patients and challenges in sample collection and processing.
EVs: Technical difficulties in detection and lack of standardized reporting.

Consider integrating circulating biomarkers into your practice for monitoring high-risk melanoma patients, especially in resource-limited settings. While these biomarkers are not yet clinically validated, they hold significant potential for improving early detection and personalized treatment strategies.

Huang N, Lee KJ, Stark MS. Current Trends in Circulating Biomarkers for Melanoma Detection. Front Med 2022;9:873728.