Gene expression profiling for molecular staging of cutaneous melanoma in patients undergoing sentinel lymph node biopsy

Pedram Gerami*, Robert W. Cook, Maria C. Russell, Jeff Wilkinson, Rodabe N. Amaria, Rene Gonzalez, Stephen Lyle, Gilchrist L. Jackson, Anthony J. Greisinger, Clare E. Johnson, Kristen M. Oelschlager, John F. Stone, Derek J. Maetzold, Laura K. Ferris, Jeffrey D. Wayne, Chelsea Cooper, Roxana Obregon, Keith A. Delman, David Lawson

*Corresponding author for this work

Research output: Contribution to journalArticle

70 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article number9981
Pages (from-to)780-785.e3
JournalJournal of the American Academy of Dermatology
Volume72
Issue number5
DOIs
StatePublished - May 1 2015

Keywords

  • cutaneous melanoma
  • gene expression profiling
  • metastasis
  • prognostic
  • sentinel lymph node biopsy
  • staging

ASJC Scopus subject areas

  • Dermatology

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    Gerami, P., Cook, R. W., Russell, M. C., Wilkinson, J., Amaria, R. N., Gonzalez, R., Lyle, S., Jackson, G. L., Greisinger, A. J., Johnson, C. E., Oelschlager, K. M., Stone, J. F., Maetzold, D. J., Ferris, L. K., Wayne, J. D., Cooper, C., Obregon, R., Delman, K. A., & Lawson, D. (2015). Gene expression profiling for molecular staging of cutaneous melanoma in patients undergoing sentinel lymph node biopsy. Journal of the American Academy of Dermatology, 72(5), 780-785.e3. [9981]. https://doi.org/10.1016/j.jaad.2015.01.009