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The 31-gene expression profile test informs sentinel lymph node biopsy decisions in patients with cutaneous melanoma: results of a prospective, multicenter study.
Yamamoto, Maki; Sickle-Santanello, Brenda; Beard, Timothy; Essner, Richard; Martin, Brian; Bailey, Christine N; Guenther, J Michael.
Afiliação
  • Yamamoto M; School of Medicine, University of California-Irvine, Orange, CA, USA.
  • Sickle-Santanello B; Surgical Oncology Associates of Columbus, Columbus, OH, USA.
  • Beard T; Bend Memorial - Total Care, Bend, OR, USA.
  • Essner R; Melanoma and Cutaneous Oncology Research Program, Saint John's Cancer Institute, Santa Monica, CA, USA.
  • Martin B; Castle Biosciences, Inc, Friendswood, TX, USA.
  • Bailey CN; Castle Biosciences, Inc, Friendswood, TX, USA.
  • Guenther JM; General Surgery, St. Elizabeth Physicians, Edgewood, KY, USA.
Curr Med Res Opin ; 39(3): 417-423, 2023 03.
Article em En | MEDLINE | ID: mdl-36617959
ABSTRACT

BACKGROUND:

The 31-gene expression profile test (Class 1A low-risk; 1B/2A intermediate-risk; 2B high-risk) is validated to identify patients with cutaneous melanoma who can safely forego sentinel lymph node biopsy (SLNB). The objective of the current study is to quantify SLNB reduction by clinicians using 31-GEP.

METHODS:

Patients with T1-T2 tumors eligible for SLNB were seen by surgical oncologists (89.1%), dermatologists (7.8%), and medical oncologists (3.1%). After receiving 31-GEP results but before SLNB, clinicians were asked which clinical and pathological features influenced SLNB decisions (n = 191). The Exact binomial test was used to compare SLNB procedure rates to a contemporary study (78% SLNB baseline rate). Logistic regression modeling (odds ratio [OR], 95% CI) was used to identify features associated with SLNB procedure rates.

RESULTS:

One hundred clinical decisions (52.4%) were influenced by the 31-GEP to forego SLNB and 70% (70/100) were not performed. Of the 30 performed, 0% (0/30) were positive. The 31-GEP influenced sixty-three clinical decisions (33.0%) to perform SLNB, and 92.1% (58/63) were performed. There was a clinically meaningful 29.4% reduction of SLNBs performed in patients with a Class 1A result relative to the baseline rate of 78.0% (p < .01). In patients ≥55 or ≥65-year-old, SLNB reduction was 32.3% (p < .01), 28.3% (p < .01), respectively. Overall, 85.3% of decisions relating to SLNB were influenced by 31-GEP results.

CONCLUSION:

In this prospective, multicenter study, clinicians demonstrated clinically meaningful use of the 31-GEP test to forego or pursue SLNB in patients with T1-T2 tumors resulting in a significant, risk appropriate decrease in SLNBs.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Melanoma Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Melanoma Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article