Identification of patients at risk of metastasis using a prognostic 31-gene expression profile in subpopulations of melanoma patients with favorable outcomes by standard criteria - 13/12/18
, Sancy Leachman, MD, PhD f, John T. Vetto, MD gAbstract |
Background |
A substantial number of patients who relapse and die from cutaneous melanoma (CM) are categorized as being at low risk by traditional staging factors. The 31-gene expression profile (31-GEP) test independently stratifies metastatic risk of patients with CM as low (Class 1, with 1A indicating lowest risk) or high (Class 2,with 2B indicating highest risk).
Objective |
To assess risk prediction by the 31-GEP test within 3 low-risk (according to the American Joint Committee on Cancer) populations of patients with CM: those who are sentinel lymph node (SLN) negative, those with stage I to IIA tumors, and those with thin (≤1 mm [T1]) tumors.
Methods |
A total of 3 previous validation studies provided a nonoverlapping cohort of 690 patients with 31-GEP results, staging information, and survival outcomes. Kaplan-Meier and Cox regression analysis were performed.
Results |
The results included the identification of 70% of SLN-negative patients who experienced metastasis as Class 2, the discovery of reduced recurrence-free survival for patients with thin tumors and Class 2B biology compared with that of those with Class 1A biology (P < .0001); and determination of the 31-GEP test as an independent predictor of risk compared with traditional staging factors in patients with stage I to IIA tumors.
Limitations |
Diagnoses spanned multiple versions of pathologic staging criteria.
Conclusions |
The 31-GEP test identifies high-risk patients who are likely to experience recurrence or die of melanoma within low-risk groups of subpopulations of patients with CM who have SLN-negative disease, stage I to IIA tumors, and thin tumors.
Le texte complet de cet article est disponible en PDF.Key words : cutaneous melanoma, gene expression profile, metastasis, prognosis, recurrence, risk, staging, survival
Abbreviations used : AJCC, BT, CM, DMFS, 31-GEP, HR, MSS, RFS, SLN, SLNB
Plan
| Funding sources: Sponsored by Castle Biosciences, Inc, which provided funding for tissue and clinical data retrieval to contributing centers. |
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| Disclosure: Dr Gastman, Dr Gerami, and Dr Vetto are members of speakers bureaus for Castle Biosciences, Inc. Dr Cook and Dr Kurley are employees and option holders of Castle Biosciences, Inc. Dr Leachman has no conflicts of interest to disclose. |
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| A portion of the findings of this article were previously presented as posters at the Society for Melanoma Research Congress, Brisbane, Australia, October 18-21, 2017 (2018, SMR Congress 2017 abstracts. Pigment Cell Melanoma Res. 2018;31:125–230); American Society of Clinical Oncology Annual Meeting, Chicago, IL, June 1-5, 2018 (J Clin Oncol. 2018;36(suppl):9583); and 2018 South Beach Symposium, Miami, FL, March 1-4, 2018. |
Vol 80 - N° 1
P. 149 - janvier 2019 Retour au numéro
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