Epigenomic monitoring of residual disease in melanoma using liquid biopsies

Melanoma is the cause of most skin cancer deaths worldwide. While surgery and adjuvant therapies are the mainstays of treatment in early melanoma, many patients relapse following treatment, as well as experience profound side effects from therapy. There is a critical need to improve the selection of patients likely to benefit from adjuvant therapy and monitor which patients are likely to relapse following treatment. Many cancers, including melanoma, can release small fragments of their DNA into a patient’s bloodstream (called circulating tumour DNA).

Circulating tumour DNA analysis can be performed from a simple blood test and may help identify patients with residual disease that has not been eradicated following treatment who are at the highest risk of relapse. This project aims to develop a highly sensitive circulating tumour DNA test for patients with melanoma, through the characterisation of circulating tumour DNA methylation patterns, to predict and monitor disease recurrence and effectively guide the delivery of adjuvant therapy to those most likely to benefit. The incorporation of circulating tumour DNA-based monitoring in melanoma management has the potential to facilitate the development of personalised treatment approaches, providing a powerful tool to significantly improve the outcomes of this disease.