Gene expression profiling for molecular staging of cutaneous melanoma in patients undergoing sentinel lymph node biopsy - 17/04/15
, Robert W. Cook, PhD d, Maria C. Russell, MD e, Jeff Wilkinson, PhD f, Rodabe N. Amaria, MD g, Rene Gonzalez, MD h, Stephen Lyle, MD i, Gilchrist L. Jackson, MD j, Anthony J. Greisinger, PhD k, Clare E. Johnson, RN d, Kristen M. Oelschlager, RN d, John F. Stone, PhD f, Derek J. Maetzold, BS d, Laura K. Ferris, MD, PhD l, Jeffrey D. Wayne, MD a, c, Chelsea Cooper, BA a, Roxana Obregon, BA a, Keith A. Delman, MD e, David Lawson, MD eAbstract |
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 (∼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.
Le texte complet de cet article est disponible en PDF.Key words : cutaneous melanoma, gene expression profiling, metastasis, prognostic, sentinel lymph node biopsy, staging
Abbreviations used : AJCC, CI, CM, DFS, DMFS, GEP, OS, SLNB
Plan
| Partially supported by Castle Biosciences Inc. |
|
| Disclosure: Drs Gerami, Ferris, and Wayne served as consultants to and speakers for Castle Biosciences. Dr Cook, Ms Johnson, Ms Oelschlager, and Mr Maetzold are employees of Castle Biosciences Inc. Drs Russell, Wilkinson, Amaria, Gonzalez, Lyle, Jackson, Greisinger, Stone, Delman, and Lawson, Ms Cooper, and Ms Obregon have no conflicts of interest to declare. |
|
| Tables and supplementary figures are available at www.jaad.org. |
Vol 72 - N° 5
P. 780 - mai 2015 Retour au numéro
Article précédent
- A clinical, histopathologic, and outcome study of melanonychia striata in childhood
- Chelsea Cooper, Nicoleta C. Arva, Christina Lee, Oriol Yélamos, Roxana Obregon, Lauren M. Sholl, Annette Wagner, Lisa Shen, Joan Guitart, Pedram Gerami
- Immunohistochemistry as a potential tool for routine detection of the NRAS Q61R mutation in patients with metastatic melanoma
- Marius Ilie, Elodie Long-Mira, Elisa Funck-Brentano, Sandra Lassalle, Catherine Butori, Virginie Lespinet-Fabre, Olivier Bordone, Alexandre Gay, Katia Zahaf, Gilles Poissonnet, Jean-Philippe Lacour, Philippe Bahadoran, Robert Ballotti, Audrey Gros, Caroline Dutriaux, Philippe Saiag, Jean-Philippe Merlio, Béatrice Vergier, Jean François Emile, Véronique Hofman, Paul Hofman
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?