Gene expression profiling for molecular staging of cutaneous melanoma in patients undergoing sentinel lymph node biopsy
Department of Molecular, Cell and Cancer Biology
Cancer Biology | Dermatology | Molecular Genetics | Neoplasms | Skin and Connective Tissue Diseases
BACKGROUND: A gene expression profile (GEP) test able to accurately identify risk of metastasis for patients with cutaneous melanoma has been clinically validated.
OBJECTIVE: We aimed for assessment of the prognostic accuracy of GEP and sentinel lymph node biopsy (SLNB) tests, independently and in combination, in a multicenter cohort of 217 patients.
METHODS: Reverse transcription polymerase chain reaction (RT-PCR) was performed to assess the expression of 31 genes from primary melanoma tumors, and SLNB outcome was determined from clinical data. Prognostic accuracy of each test was determined using Kaplan-Meier and Cox regression analysis of disease-free, distant metastasis-free, and overall survivals.
RESULTS: GEP outcome was a more significant and better predictor of each end point in univariate and multivariate regression analysis, compared with SLNB (P < .0001 for all). In combination with SLNB, GEP improved prognostication. For patients with a GEP high-risk outcome and a negative SLNB result, Kaplan-Meier 5-year disease-free, distant metastasis-free, and overall survivals were 35%, 49%, and 54%, respectively.
LIMITATIONS: Within the SLNB-negative cohort of patients, overall risk of metastatic events was higher ( approximately 30%) than commonly found in the general population of patients with melanoma.
CONCLUSIONS: In this study cohort, GEP was an objective tool that accurately predicted metastatic risk in SLNB-eligible patients. Inc. All rights reserved.
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Citation: J Am Acad Dermatol. 2015 May;72(5):780-785.e3. doi: 10.1016/j.jaad.2015.01.009. Epub 2015 Mar 3. Link to article on publisher's site
Gerami, Pedram; Cook, Robert W.; Russell, Maria C.; Wilkinson, Jeff; Amaria, Rodabe N.; Gonzalez, Rene; Lyle, Stephen; Jackson, Gilchrist L.; Greisinger, Anthony J.; Johnson, Clare E.; Oelschlager, Kristen M.; Stone, John F.; Maetzold, Derek J.; Ferris, Laura K.; Wayne, Jeffrey D.; Cooper, Chelsea; Obregon, Roxana; Delman, Keith A.; and Lawson, David, "Gene expression profiling for molecular staging of cutaneous melanoma in patients undergoing sentinel lymph node biopsy" (2015). Molecular, Cell and Cancer Biology Publications. 11.