John T Vetto1, Eddy C Hsueh2, Brian R Gastman3, Larry D Dillon4, Federico A Monzon5, Robert W Cook5, Jennifer Keller2, Xin Huang6, Andrew Fleming6, Preston Hewgley6, Pedram Gerami7,8,9, Sancy Leachman10, Jeffrey D Wayne7,8,11, Adam C Berger12, Martin D Fleming6. 1. Division of Surgical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA. 2. Department of Surgery, St Louis University, St Louis, MO 63110, USA. 3. Department of Plastic Surgery, Cleveland Clinic Lerner Research Institute, Cleveland, OH 44915, USA. 4. Larry D Dillon Surgical Oncology & General Surgery, Colorado Springs, CO 80907, USA. 5. Castle Biosciences, Inc., Friendswood, TX 77546, USA. 6. Division of Surgical Oncology, Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN 38163, USA. 7. Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago IL 60611, USA. 8. Skin Cancer Institute, Northwestern University, Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA. 9. Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago IL 60611, USA. 10. Department of Dermatology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA. 11. Department of Surgical Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. 12. Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19017, USA.
Abstract
AIM: Can gene expression profiling be used to identify patients with T1-T2 melanoma at low risk for sentinel lymph node (SLN) positivity? PATIENTS & METHODS: Bioinformatics modeling determined a population in which a 31-gene expression profile test predicted <5% SLN positivity. Multicenter, prospectively-tested (n = 1421) and retrospective (n = 690) cohorts were used for validation and outcomes, respectively. RESULTS: Patients 55-64 years and ≥65 years with a class 1A (low-risk) profile had SLN positivity rates of 4.9% and 1.6%. Class 2B (high-risk) patients had SLN positivity rates of 30.8% and 11.9%. Melanoma-specific survival was 99.3% for patients ≥55 years with class 1A, T1-T2 tumors and 55.0% for class 2B, SLN-positive, T1-T2 tumors. CONCLUSION: The 31-gene expression profile test identifies patients who could potentially avoid SLN biopsy.
AIM: Can gene expression profiling be used to identify patients with T1-T2 melanoma at low risk for sentinel lymph node (SLN) positivity? PATIENTS & METHODS: Bioinformatics modeling determined a population in which a 31-gene expression profile test predicted <5% SLN positivity. Multicenter, prospectively-tested (n = 1421) and retrospective (n = 690) cohorts were used for validation and outcomes, respectively. RESULTS:Patients 55-64 years and ≥65 years with a class 1A (low-risk) profile had SLN positivity rates of 4.9% and 1.6%. Class 2B (high-risk) patients had SLN positivity rates of 30.8% and 11.9%. Melanoma-specific survival was 99.3% for patients ≥55 years with class 1A, T1-T2 tumors and 55.0% for class 2B, SLN-positive, T1-T2 tumors. CONCLUSION: The 31-gene expression profile test identifies patients who could potentially avoid SLN biopsy.
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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
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