Use of circulating tumour DNA to prospectively guide a switch from targeted to immune therapy in BRAF mutant advanced melanoma: the randomised phase II CAcTUS trial
Blood tumor DNA levels can reliably guide melanoma patients to switch treatments within a week, potentially improving outcomes when resistance develops.
The CAcTUS randomized phase II feasibility trial demonstrated that ctDNA BRAF-VAF monitoring can reliably guide real-time treatment switching from targeted therapy to immunotherapy in advanced melanoma within clinically actionable timeframes (100% within 7 days). Post-hoc analysis showed ctDNA at nadir predicted a favorable immunological profile prior to checkpoint inhibitor initiation, supporting ctDNA-guided treatment optimization in BRAF mutant melanoma.
What the study was
- Study design
- Parallel-arm randomized phase II feasibility trial
- Population
- BRAF mutant advanced melanoma patients
- Sample size
- 21
- Category
- Treatment Innovation
- Maturity
- Validated
- Journal
- Nat Commun
Why it surfaced
First randomized trial demonstrating ctDNA-guided prospective treatment sequencing in BRAF mutant melanoma; Nat Commun publication; feasibility primary endpoints met 100%; ctDNA as actionable real-time biomarker for immunotherapy sequencing decisions.
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