Guidelines Issued for Gene Expression Profiling in Cutaneous Melanoma
GEP results can improve prognostic assessment for patients with tumors with uncertainty about adequacy of microstaging
By Dermsquared Editorial Team | January 25, 2023
In an expert consensus panel report published in the January issue of SKIN, clinical management recommendations are presented for the use of gene expression profile (GEP) testing in the assessment of cutaneous melanoma (CM).
Danny Zakria, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues created updated guidelines and consensus statements for optimal use of commercially available GEP tests, used in prognostic assessment of CM. Twenty-two articles were included that validated the 31-GEP test, two that validated the 11-GEP test, and seven that validated the 8-GEP clinicopathologic test.
The researchers generated six usage guidelines and five consensus statements, which were unanimously approved. Usage guidelines with a Strength of Recommendation Taxonomy (SORT) level of A included integration of GEP results for patients with T1a tumors at least 0.3 mm in depth, T1b tumors, or any tumor in which there is significant uncertainty about adequacy of microstaging to improve prognostic assessment. For traditionally assessed low-risk patients, a high-risk subset for recurrence, distant metastasis, or death can be identified by GEP testing. GEP testing provides useful information to augment risk-aligned management decisions to rule in or rule out the need for sentinel lymph node biopsy and subsequent management plans. Guidelines with a SORT level of B include adding GEP results to clinicopathologic information to improve CM prognosis assessment and adding GEP results to the American Joint Committee on Cancer classification to improve prognostic assessment of cutaneous melanoma.
"The expert consensus guidelines and support statements presented here will hopefully provide a framework for the clinician to integrate GEP testing into their CM patient management," the authors write.
Several authors disclosed financial ties to biopharmaceutical companies, including Castle Biosciences, which partially funded the study.