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.
Il testo completo di questo articolo è disponibile in 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
Mappa
| Partially supported by Castle Biosciences Inc. |
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| 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. |
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| Tables and supplementary figures are available at www.jaad.org. |
Vol 72 - N° 5
P. 780 - maggio 2015 Ritorno al numero
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