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The aim of this pilot study was to determine if circulating tumor cells (CTCs) are associated with shortened (180-day) progression-free survival (PFS) after a baseline CTC assessment in stage IV melanoma patients.

All patients had a baseline CTC assessment performed with CellSearch®.

Budd et al. found CTC assessment to be predictive of survival in both patients with and without radiological progression [ 5].

Both modalities were rated blinded to CTC-assessments.

Baseline CTC-status was not predictive for PFS, neither by categorical nor by continuous CTC-assessments (Table  4).

Among 70 cfDNA and 39 CTC samples of overt myeloma samples (newly diagnosed or relapsed), there were 76%, 41%, and 24% of cfDNA samples with ≥3%, 5%, and 10% tumor fractions, respectively (Fig. 1c, blue panel).

MM_2205 CTC sample used 0.7 power due to lower coverage.

Outcome assessment and sample size requirements.

30/31 (96.8%) samples had at least 1 CTC, 15/31 (48.4%) samples at least 10 CTCs, with CTC total counts ranging from 0.1 to 9.67 CTCs/mL of blood (Table 1, Fig. 2B).

We applied our integrated workflow to 107 cfDNA samples and 56 CTC samples with different stages of disease progression.

For instance, a TP53 subclone was only detected in cfDNA and CTCs in sample MM_2017 (Fig. 5a, c and Fig. 6a, c).