US physician perspective on the use of biomarker and ctDNA testing in patients with melanoma

New treatments have increased survival of patients with melanoma, and methods to monitor patients throughout the disease process are needed. Circulating tumor DNA (ctDNA) is a predictive and prognostic biomarker that may allow routine, real-time monitoring of disease status. We surveyed 44 US physicians to understand their preferences and practice patterns for biomarker and ctDNA testing in their patients with melanoma. Tumor biomarker testing was often ordered in stage IIIA-IV patients. Barriers to biomarker testing include insufficient tissue (60%) and lack of insurance coverage (54%). ctDNA testing was ordered by 16–18% of physicians for stages II-IV. Reasons for not using ctDNA testing included lack of prospective data (41%), ctDNA testing used for research only (18%), and others. Physicians (≥74%) believed that ctDNA assays could help with monitoring and treatment selection throughout the disease process. Physicians consider ctDNA testing potentially valuable for clinical decision-making but cited concerns that should be addressed. •We surveyed 44 physicians from 18 states about their use of ctDNA for patients with melanoma.•Up to 84% of physicians ordered a tumor biomarker test for stage III-IV melanoma.•ctDNA testing awareness was 90% but only 39% of physicians ordered a ctDNA test.•Physicians cited concerns about ctDNA testing such as lack of prospective data.•Concerns about cost/insurance and that ctDNA is for research were also stated.