{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:57:23Z","timestamp":1793141843311,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pigment Cell Melanoma Res"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Metastatic uveal melanoma (mUM) is a rare disease associated with poor prognosis and limited therapeutic options. Recent studies showed that detecting ctDNA is feasible and can aid treatment decisions for patients with mUM. We systematically searched PubMed, EMBASE, and Cochrane databases for eligible studies published up to May 2025 that included patients with mUM and reported data on the association between ctDNA and survival outcomes (OS and PFS). Statistical analyses were performed using Review Manager 5.4 software. Of the initial 450 records, seven studies met eligibility, including 518 patients with mUM. At baseline, ctDNA positivity was associated with significantly worse PFS (HR 2.34; 95% CI 1.56\u20133.51;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090%) and OS (HR 3.32; 95% CI 2.09\u20135.29;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200948%). In patients treated with tebentafusp, ctDNA clearance was associated with superior OS (HR 0.19; 95% CI 0.07\u20130.49;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200946%) and any decrease in ctDNA was associated with better OS (HR 0.42; 95% CI 0.22\u20130.80;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090%). This meta\u2010analysis underscores ctDNA as a potential predictor of worse survival in patients with mUM, highlighting its potential to refine risk stratification and guide treatment strategies.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    International Prospective Register of Systematic Reviews (PROSPERO): CRD42025638076\n                  <\/jats:p>","DOI":"10.1111\/pcmr.70047","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T07:10:58Z","timestamp":1755069058000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prognostic and Predictive Value of ct\n                    <scp>DNA<\/scp>\n                    for Metastatic Uveal Melanoma: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0889-7425","authenticated-orcid":false,"given":"Mariana Macambira","family":"Noronha","sequence":"first","affiliation":[{"name":"Department of Medical Sciences Universidade Federal do Cear\u00e1  Fortaleza Cear\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8347-1212","authenticated-orcid":false,"given":"Lu\u00eds Felipe Leite","family":"da Silva","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Universidade Federal Fluminense  Niteroi Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3286-3333","authenticated-orcid":false,"given":"Luiz Felipe Costa","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Universidade Federal Fluminense  Niteroi Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9049-0996","authenticated-orcid":false,"given":"Pedro Robson Costa","family":"Passos","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Universidade Federal do Cear\u00e1  Fortaleza Cear\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8710-1784","authenticated-orcid":false,"given":"Pedro Cotta Abrah\u00e3o","family":"Reis","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Universidade Federal do Rio de Janeiro  Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Evangelista Ponte","family":"Conrado","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Universidade Federal do Cear\u00e1  Fortaleza Cear\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2864-0966","authenticated-orcid":false,"given":"Valbert Oliveira Costa","family":"Filho","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Universidade Federal do Cear\u00e1  Fortaleza Cear\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Diniz","family":"da Concei\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Universidade Federal Fluminense  Niteroi Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5602-164X","authenticated-orcid":false,"given":"Mauricio F. S. A.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Sarcoma Department H. Lee Moffitt Cancer Center and Research Institute  Tampa Florida USA"},{"name":"Department of Oncologic Sciences University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4477-8258","authenticated-orcid":false,"given":"Samuel D.","family":"Saibil","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Canada"},{"name":"Division of Medical Oncology and Hematology Princess Margaret Cancer Centre  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7972-4244","authenticated-orcid":false,"given":"Erick F.","family":"Saldanha","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Canada"},{"name":"Division of Medical Oncology and Hematology Princess Margaret Cancer Centre  Toronto Canada"},{"name":"Harvard T. H. 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