Biomarkers in advanced melanoma

Immune checkpoint inhibitors have revolutionised the treatment of advanced cancer, leading to durable tumour shrinkage across multiple cancer types. However, response is only seen in a subset of patients and immune related adverse events that mimic autoimmune disease may occur, irrespective of response. There is an urgent need for biomarkers that predict response and toxicity to determine which patients will benefit most from these potentially toxic therapies. The continuous release of tumour microenvironment derived genomic and proteomic material into the circulation has the potential to be used as a biomarker of response and survival. Therefore, its role in personalised therapy, prognostication and predicting immune related adverse events warrants investigation.