Expanded evidence that the 31-gene expression profile test provides clinical utility for melanoma management in a multicenter study

Larry D. Dillon, Michael McPhee, Robert S. Davidson, Ann P. Quick, Brian Martin, Kyle R. Covington, Olga Zolochevska, Robert W. Cook, John T. Vetto, Abel D. Jarell, Martin D. Fleming

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: National Comprehensive Cancer Network (NCCN) guidelines for cutaneous melanoma (CM) recommend physicians consider increased surveillance for patients who typically have lower melanoma survival rates (stages IIB-IV as determined by the American Joint Committee on Cancer (AJCC), 8th edition). However, up to 15% of patients identified as having a low recurrence risk (stages I-IIA) experience disease recurrence, and some patients identified as having a high recurrence risk will not experience any recurrence. The 31-gene expression profile test (31-GEP) stratifies patient recurrence risk into low (Class 1) and high (Class 2) and has demonstrated risk-appropriate impact on disease management and clinical decisions. Methods: Five-year plans for lab work, frequency of clinical visits, and imaging pre- and post-31-GEP test results were assessed for a cohort of 509 stage I-III patients following an interim subset analysis of 247 patients. Results: After receiving 31-GEP results, 50.6% of patients had a change in management plans in at least one of the following categories—clinical visits, lab work, or surveillance imaging. The changes aligned with the risk predicted by the 31-GEP for 76.1% of patients with a Class 1 result and 78.7% of patients with a Class 2 result. A Class 1 31-GEP result was associated with changes toward low-intensity management recommendations, while a Class 2 result was associated with changes toward high-intensity management recommendations. Conclusion: The 31-GEP can stratify patient recurrence risk in patients with CM, and clinicians understand and apply the prognostic ability of the 31-GEP test to alter patient management in risk-appropriate directions.

Original languageEnglish (US)
JournalCurrent Medical Research and Opinion
DOIs
StateAccepted/In press - 2022
Externally publishedYes

Keywords

  • gene expression profiling
  • Melanoma
  • neoplasm staging
  • prognosis

ASJC Scopus subject areas

  • Medicine(all)

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