Background: Cutaneous melanoma (CM) is a significant health concern because of its high metastatic potential. Gene Expression Profile (GEP) testing, particularly the 31-GEP test (DecisionDx-Melanoma), has been increasingly used for risk stratification in CM patients. This study aimed to evaluate the clinical utility and performance of the 31-GEP test in a real-world setting.
Methods: Patients with CM who underwent 31-GEP testing from August 2014 to August 2022 at our institution were identified through searches of electronic health records. The study analyzed the influence of 31-GEP testing on clinical decision-making related to sentinel lymph node biopsy (SLNB), medical oncology referral, and postdiagnosis surveillance. Kaplan-Meier curves and Cox proportional hazard models were used to elucidate the test's performance, focusing on relapse-free survival (RFS) and melanoma-specific survival (MSS).
Results: The study included 65 CM patients. Dermatologists ordered more than 80% of 31-GEP tests. In 81.5% of cases, 31-GEP results did not alter standard clinical management. SLNB decisions were unaffected in 92% of patients with pre-SLNB 31-GEP results. Among patients with stage I-IIA melanoma, 25% of those with high-risk 31-GEP results were referred to medical oncology. Contrary to expectations, the rate of nodal metastasis was higher in low-risk than in high-risk 31-GEP cases. Survival analysis showed overlapping RFS and MSS curves between different 31-GEP classes, suggesting limited prognostic value.
Conclusions: The 31-GEP test has a limited impact on clinical management decisions and shows limited prognostic value.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/ijd.17440 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Prognostic Value of the 31-Gene Expression Profile Test in Cutaneous Melanoma: A Systematic Review and Meta-Analysis.
Cancers (Basel)
November 2024
Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA.
Background: Cutaneous melanoma is an increasingly common and potentially lethal form of skin cancer. Current staging systems based on clinical and pathological features have limitations in accurately predicting outcomes, particularly for early-stage disease. The 31-gene expression profile (31-GEP) test has emerged as a promising tool for improving risk stratification in melanoma patients.
View Article and Find Full Text PDFSociety of Surgical Oncology Consensus Statement: Assessing the Evidence for and Utility of Gene Expression Profiling of Primary Cutaneous Melanoma.
Ann Surg Oncol
October 2024
Hospital of the University of Pennsylvania, University of Pennsylvania Abramson Cancer Center, Philadelphia, PA, USA.
Introduction: Gene expression profiling (GEP) of primary cutaneous melanoma aims to offer prognostic and predictive information to guide clinical care. Despite limited evidence of clinical utility, these tests are increasingly incorporated into clinical care.
Methods: A panel of melanoma experts from the Society of Surgical Oncology convened to develop recommendations regarding the use of GEP to guide management of patients with melanoma.
Genetic analysis of metastatic versus nonmetastatic conjunctival melanoma using a cutaneous melanoma gene expression panel.
Can J Ophthalmol
October 2024
Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, United States. Electronic address:
Article Synopsis
- Conjunctival melanoma (CJM) is a rare form of mucosal melanoma, and understanding its genetics is improving, but predicting patient outcomes remains difficult; this study investigates whether a 31-gene expression profile test (originally for skin melanoma) can help in prognosis for CJM patients.* -
- The study involved a review of 10 CJM patients, using archived tumor samples to perform gene expression testing, with follow-up for patient outcomes such as recurrence and metastasis over a minimum of 5 years.* -
- Results showed that 50% of patients developed metastatic disease, significantly impacting survival rates, and highlighted that reduced expression of the gene BAP1 may play a crucial role in determining metastatic risk
Use of the 31-Gene Expression Profile Test to Aid in the Decision of Adjuvant Treatment of Cutaneous Melanoma.
J Adv Pract Oncol
May 2024
From Cincinnati Cancer Advisors, Cincinnati, Ohio.
Melanoma is the fifth most common cancer in the United States, with over 7,000 deaths annually. Although most patients diagnosed with early-stage (stage I or II) disease have an excellent prognosis, two out of three patients who die from melanoma were initially diagnosed in early stages. Thus, additional methods to identify which patients are at risk of poor outcomes are needed.
View Article and Find Full Text PDFArticle Synopsis
- - The expert panel focused on advancing the diagnosis and prognosis of cutaneous melanoma (CM) due to its high mortality rate, reviewing new tech advancements like gene expression profiling (GEP) and electrical impedance spectroscopy (EIS).
- - A thorough literature search resulted in 200 articles, but only 19 were selected for review, leading to 7 consensus statements on testing approaches, categorized by varying levels of recommendation strength.
- - Key findings suggest that specific GEP tests can help accurately diagnose unclear cases and enhance prognostic evaluations, ultimately supporting better clinical decisions for CM patients.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!