1. Associate Professor Elin Gray
Blood Biomarkers for Diagnosis, Prognosis and Monitoring of Melanoma Patients
Associate Professor Elin Gray
Melanoma Research Group
School of Medical and Health Sciences
Edith Cowan University, Perth, Western Australia

2. Blood Biomarkers of Cancer
Easily accessible
Can be regularly tested
Real-time monitoring
AutoAbs
AuAbs
Alix-Panabieres & Pantel, Nature Biomedical Engineering 2017
Wan et al., Nature Reviews Cancer 2017

3. Cancer Liquid Biopsy – Just from a blood sample
MelDx
Pauline Zaenker

4. Autoantibodies as Diagnostic Melanoma Biomarkers
84% Specificity
79% Sensitivity
Discovery phase
Zaenker et al., Oncotarget 2018
routine skin check
MelDx trial

5. MelDx Study Design
Hypothesis Autoantibody positivity in sera using the MelDx test will correspond with histological diagnosis of melanoma via biopsy. Primary Aim To validate a combination of autoantibodies that provide diagnostic accuracy of 80% or greater in early stage melanoma. Secondary Aim To evaluate whether a history of skin cancers affects the test results. To evaluate the specificity of MelDx for melanoma relative to other skin cancers, other cancers and autoimmune diseases.

6. MelDx Study – your input
1. In what situation would an additional test (ie.: a blood test) be useful?
How accurate would a test have to be for you to consider using it (what %)?
When you are looking for additional diagnostic tools/tests, what is the main factor that influences your decision to implement these?

7. Overall requirements
If you want to get involved Written consent Once-off 2xSST tubes (6ml) Access to biopsy pathology report collaboration on papers, grants, etc.
Contact:
Dr. Pauline Zaenker
(08)

8. Cancer Liquid Biopsy – Just from a blood sample
CNV on CTCs
Aaron Beasley
Beasley et al., JCO Precision Oncology 2018
Non-invasive prognostication of uveal melanoma
Cancer Liquid Biopsy – Just from a blood sample
Blood test for early detection of melanoma
MelDx
Pauline Zaenker
Khattak et al., The Oncologist 2019
All CD45/CD16 PD-L MEL Nucleus
PD-L1 expression on CTCs predicts pembrolizumab outcomes
Adnan Khattak
Zaenker et al., Oncotarget 2018

9. Cancer Liquid Biopsy – Just from a blood sample
Circulating Tumour DNA
Gray et al., Oncotarget 2015

10. Tumour size and metabolic activity correlates with ctDNA shedding
Ashleigh McEvoy
Zeyad Al-Ogaili
MTB: Metabolic Tumour Burden
MTV: Metabolic Tumour Volume
McEvoy et al., BMC cancer 2018

11. ctDNA allows non-invasive assessment of genomic alterations of the tumour
QiaSeq Custom Melanoma Panel
950 amplicons over 30 genes
Unique Molecular Identifiers
Detection of BRAF mutant melanoma in tissue vs liquid biopsies
Negative Agreement 66/66 (100%)
Overall Agreement /153 (88%)
False Positive %
False Negative %
Sensitivity %
Specificity %
Tumour and plasma pairs N=7
Plasma
Tumour 3 25 6
TruSeq Illumina Custom Melanoma Panel
950 amplicons over 30 genes
Benhur Amanuel
PathWest
Leslie Calapre

12. ctDNA positivity predicts survival of Stage III melanoma patients
Before SLND
After SLND
Before SLND
Before SLND (Validation cohort)
Tan et al., Annals of Oncol (PeterMac/Christie)
Lee et al., Annals of Oncol 2019 (MIA)

13. Study Participants and Healthy Volunteers
Acknowledgements
MelDx
Melanoma Institute Australia
Study Participants and Healthy Volunteers
Lester Cowell
Christopher Quirk
Tony Caccetta
Stephanie Weston
Prasad Kumarasinghe
Geoffrey Shulman
Daniel Hewitt
Gordon Harloe
Johnny Lo
Georgina V. Long
Richard A. Scolyer
Matteo S. Carlino
SCGH and FSH
PathWest
QIMR
Macquarie University
Michael Millward
Adnan Khattak
Tarek Meniawy
Lydia Warburton
Zeyad Al-Ogaili
Tim Isaacs
Fred Chen
Ben Wood
Nima Meshba
Tindaro Giardina
Cleo Robinson
Benhur Amanuel
Peter Johansson
Nicholas Hayward
Helen Rizos
Jenny Lee
Harvard University
Markus Frank
Ryan Sullivan
Xin Hong
Edith Cowan University
Melanoma Research Group