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Tools that Identify High-Risk Melanomas Examined
J Am Acad Dermatol; ePub 2017 Jan 19; Ferris, et al
A 31-gene expression profile (GEP) provides valuable prognostic information and improves identification of high-risk melanomas when used together with the American Joint Committee on Cancer (AJCC) online prediction tool, a recent study found. GEP results from 205 stage I/II cutaneous melanomas with sufficient clinical data for prognostication using the AJCC tool were classified as low (class 1) or high (class 2) risk. 2 5-year overall survival cutoffs (AJCC 79% and 68%), reflecting survival for patients with stage IIA or IIB disease, respectively, were assigned for binary AJCC risk. Researchers found:
- Cox univariate analysis revealed significant risk classification of distant metastasis-free and overall survival (HR range 3.2-9.4) for both tools.
- In all, 43 (21%) cases had discordant GEP and AJCC classification (using 79% cutoff).
- 11 of 13 (85%) deaths in that group were predicted as high risk by GEP but low risk by AJCC.
Ferris LK, Farberg AS, Middlebrook B, et al. Identification of high-risk cutaneous melanoma tumors is improved when combining the online American Joint Committee on Cancer Individualized Melanoma Patient Outcome Prediction Tool with a 31-gene expression profile–based classification. [Published online ahead of print January 19, 2017]. J Am Acad Dermatol. doi:10.1016/j.jaad.2016.11.051.