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How do you discuss 40-GEP test results with patients?

Featuring Darrell Rigel, MD, MS | Senior Clinical Advisor |

Clinical Professor of Dermatology 
New York University
Grossman School of Medicine
New York, NY 
Adjunct Professor
UT Southwestern Medical School 
Consultant Dermatologist, Cooper Clinic
Dallas, TX

| Published August 01, 2023


Dr. Darrell Rigel discusses how he approaches the discussion of 40-GEP (Genomic Expression Profile) test results with his patients. He emphasizes the importance of having a frank conversation with the patients about their test results. The 40-GEP test results are relatively easy for patients to understand because they are categorized into three levels of risk: low risk, mid-risk, and high risk. Depending on which risk category the patient falls into, Dr. Rigel tailors his discussion accordingly. For patients with low-risk results, Dr. Rigel can confidently inform them that there is no need for advanced treatments or additional therapies beyond close monitoring. However, for patients in the mid-risk or high-risk category, he may discuss the possibility of additional therapies such as adjuvant radiation or the use of specific medications like cemiplimab, PD1 inhibitors, or other more advanced treatments. The primary goal of discussing these test results with patients is to provide them with a clear understanding of their risk level and prognosis. This information allows for informed decision-making regarding the necessity and potential benefits of further treatment options, ensuring the best possible care for each individual patient. 

Key Points 
  • 40-GEP test results are easy for patients to understand as they are categorized into three levels of risk: low, mid risk, and high risk. 
  • The degree of risk and prognosis are used to determine whether additional therapy is necessary, and the doctor should tailor their discussion with the patient accordingly. 
  • Treatment options discussed with mid to high-risk patients may include adjuvant radiation, cemiplimab, PD1 inhibitors, or more advanced treatments. 
  • For low-risk patients, the need for advanced treatments is deemed unnecessary, and close patient monitoring may suffice.

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