Fixed tissues are the standard samples used in routine practice for molecular testing.,But sometimes tissues are lacking or difficult to obtain.,In these cases, circulating tumor DNA released from tumor cells can be used as an alternative source of tumor DNA.,We present the case of a 63-year-old Caucasian woman with a metastatic melanoma and a very poor performance status.,A plasma sample was tested and the BRAF p.V600E mutation was detected.,Based on this result, a treatment combining a BRAF inhibitor and a MEK inhibitor was immediately started.,This patient achieved a complete response.,In addition, by repeating the plasma test, we could obtain a precise kinetic of release of mutated BRAF DNA in plasma.,We report here for the first time the efficient treatment of a metastatic melanoma patient on the basis of circulating tumor DNA analysis.,This urgent treatment provided a dramatic response in a patient with a very poor initial condition.,The kinetic data most likely reflect treatment efficacy.
Outcomes for melanoma patients with stage III disease differ widely even within the same subcategory.,Molecular signatures that more accurately predict prognosis are needed to stratify patients according to risk.,Proteomic analyses were used to identify differentially abundant proteins in extracts of surgically excised samples from patients with stage IIIc melanoma lymph node metastases.,Analysis of samples from patients with poor (n = 14, <1 yr) and good (n = 19, >4 yr) survival outcomes identified 84 proteins that were differentially abundant between prognostic groups.,Subsequent selected reaction monitoring analysis verified 21 proteins as potential biomarkers for survival.,Poor prognosis patients are characterized by increased levels of proteins involved in protein metabolism, nucleic acid metabolism, angiogenesis, deregulation of cellular energetics and methylation processes, and decreased levels of proteins involved in apoptosis and immune response.,These proteins are able to classify stage IIIc patients into prognostic subgroups (P < 0.02).,This is the first report of potential prognostic markers from stage III melanoma using proteomic analyses.,Validation of these protein markers in larger patient cohorts should define protein signatures that enable better stratification of stage III melanoma patients.