Prithvi Mruthyunjaya1, Michael I Seider2, Sandra Stinnett3, Amy Schefler4. 1. Department of Ophthalmology, Duke University, Durham, North Carolina; Department of Radiation Oncology, Duke University, Durham, North Carolina; Department of Ophthalmology, Stanford University, Palo Alto, California. Electronic address: prithvi9@stanford.edu. 2. Department of Ophthalmology, Duke University, Durham, North Carolina; Department of Ophthalmology, The Permanente Medical Group, San Francisco, California; Department of Ophthalmology, Univerisity of California, San Francisco, California. 3. Department of Ophthalmology, Duke University, Durham, North Carolina. 4. Retina Consultants of Houston, Houston, Texas; Blanton Eye Institute at Houston Methodist Hospital, Houston, Texas.
Abstract
PURPOSE: Gene expression profile (GEP) testing segregates uveal melanoma (UM) into 2 main prognostic classes. It is unknown if a greater tumor regression response after iodine 125 (I125) brachytherapy correlates with class 2 GEP status. The purpose of this study was to determine whether there is a significant relationship between the rate of UM height regression and GEP classification testing after I125 plaque brachytherapy. DESIGN: Multicenter, retrospective cohort study. PARTICIPANTS: Adult UM patients treated with I125 plaque brachytherapy who had concurrent tumor biopsy at the time of surgery with a GEP test result from January 1, 2010 through June 30, 2014. METHODS: Baseline clinical data and GEP class assignments were obtained. The ultrasonographic tumor height was recorded at baseline and at 3, 6, 9, and 12 months and at the most recent final follow-up visits. Subanalysis of paired cases based on pretreatment ultrasound height was performed. Statistical analysis was performed using Wilcoxon rank-sum tests, the Fisher exact test, and Kaplan-Meier analysis. MAIN OUTCOME MEASURES: Percentage change in tumor height from baseline. RESULTS: A total of 353 patients were included in the study. Median follow-up was 2.1 years (range, 0.5-5.3 years). Gene expression profile status was class 1 in 247 tumors (70%) and class 2 in 106 tumors (30%). Increased patient age, larger tumor dimensions, and greater tumor thickness were associated with class 2 GEP status (P = 0.006, P < 0.001, and P < 0.001, respectively). The percentage reduction in tumor height from baseline was significantly greater in class 1 than class 2 tumors at 3 months (17.5% vs. 11.8%; P = 0.007) and 6 months (26.8% vs. 17.1%; P = 0.007), respectively, but there was no significant difference in reduction between class 1 and 2 tumors at 9 months (P = 0.26) and 12 months (P = 0.57) after treatment. Class 1A and 1B tumors showed similar reduction compared with class 2 tumors (P < 0.05). CONCLUSIONS: Class 1 UM tumors tend to regress more rapidly than class 2 tumors in the first 6 months after plaque radiotherapy. Class 1A and 1B tumors regress at similar rates after plaque radiotherapy.
PURPOSE: Gene expression profile (GEP) testing segregates uveal melanoma (UM) into 2 main prognostic classes. It is unknown if a greater tumor regression response after iodine 125 (I125) brachytherapy correlates with class 2 GEP status. The purpose of this study was to determine whether there is a significant relationship between the rate of UM height regression and GEP classification testing after I125 plaque brachytherapy. DESIGN: Multicenter, retrospective cohort study. PARTICIPANTS: Adult UM patients treated with I125 plaque brachytherapy who had concurrent tumor biopsy at the time of surgery with a GEP test result from January 1, 2010 through June 30, 2014. METHODS: Baseline clinical data and GEP class assignments were obtained. The ultrasonographic tumor height was recorded at baseline and at 3, 6, 9, and 12 months and at the most recent final follow-up visits. Subanalysis of paired cases based on pretreatment ultrasound height was performed. Statistical analysis was performed using Wilcoxon rank-sum tests, the Fisher exact test, and Kaplan-Meier analysis. MAIN OUTCOME MEASURES: Percentage change in tumor height from baseline. RESULTS: A total of 353 patients were included in the study. Median follow-up was 2.1 years (range, 0.5-5.3 years). Gene expression profile status was class 1 in 247 tumors (70%) and class 2 in 106 tumors (30%). Increased patient age, larger tumor dimensions, and greater tumor thickness were associated with class 2 GEP status (P = 0.006, P < 0.001, and P < 0.001, respectively). The percentage reduction in tumor height from baseline was significantly greater in class 1 than class 2 tumors at 3 months (17.5% vs. 11.8%; P = 0.007) and 6 months (26.8% vs. 17.1%; P = 0.007), respectively, but there was no significant difference in reduction between class 1 and 2 tumors at 9 months (P = 0.26) and 12 months (P = 0.57) after treatment. Class 1A and 1B tumors showed similar reduction compared with class 2 tumors (P < 0.05). CONCLUSIONS: Class 1 UM tumors tend to regress more rapidly than class 2 tumors in the first 6 months after plaque radiotherapy. Class 1A and 1B tumors regress at similar rates after plaque radiotherapy.
Authors: Duncan E Berry; Amy C Schefler; Michael I Seider; Miguel Materin; Sandra Stinnett; Prithvi Mruthyunjaya Journal: Retina Date: 2018-11-08 Impact factor: 4.256
Authors: Christina Binder; Prithvi Mruthyunjaya; Amy C Schefler; Michael I Seider; Richard Crilly; Arthur Hung; Sheridan Meltsner; Yvonne Mowery; David G Kirsch; Bin S Teh; Richard L S Jennelle; Matthew T Studenski; Wu Liu; Choonik Lee; James A Hayman; Brian Kastner; Michael Hadsell; Alison H Skalet Journal: Ocul Oncol Pathol Date: 2019-12-11
Authors: Douglas Grossman; Caroline C Kim; Rebecca I Hartman; Elizabeth Berry; Kelly C Nelson; Nwanneka Okwundu; Clara Curiel-Lewandrowski; Sancy A Leachman; Susan M Swetter Journal: Melanoma Manag Date: 2019-12-17
Authors: Duncan E Berry; Amy C Schefler; Michael I Seider; Miguel Materin; Sandra Stinnett; Prithvi Mruthyunjaya Journal: Retina Date: 2020-02 Impact factor: 3.975