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When to Use A Melanoma Genomic Test for Predicting Prognosis and Guiding Management

SKIN-The Journal of Cutaneous Medicine®: Establishing an evidence-based decision point for clinical use of the 31-gene expression profile test in melanoma

The 31-GEP test was developed and validated to enhance prognostic accuracy in melanoma.”
— Etan Marks, DO
NEW YORK, NY, UNITED STATES, July 8, 2019 / -- Melanoma is the deadliest form of skin cancer. It can be very aggressive once it has metastasized from its original location on the skin to other organs of the body. Fortunately, there have been extensive medical advances in both the treatment and long-term management of this type of cancer. One such advance is a genetic test that can determine a patient’s likelihood to develop a metastatic melanoma during the 5 year period after diagnosis. Although most melanomas are found early (when they are thin) and are cured by a simple skin excision, the majority of deaths from melanoma come from this “low risk” group rather than those who initially present with widespread disease.

Testing a patient’s particular melanoma genome can help individualize patient care. The 31-gene expression profile (31-GEP) test from Castle Biosciences is a test that can determine whether a melanoma patient has a high or low risk of developing a metastases after diagnosis based on certain DNA features. However, the test should not be used indiscriminately in all patients who are diagnosed with melanoma. A recent article published in SKIN: The Journal of Cutaneous Medicine helps to shed light on when exactly this test should be ordered by analyzing a large dataset of patients who had undergone prognostic testing and determining which patients had changes in management as a result of their test results.

Authored by Marks et al, the article writes “Patients with thin melanoma represent the majority of cutaneous melanoma patients and a subset of these patients have poor outcomes, which accounts for a significant percentage of melanoma-related deaths. The 31-GEP test was developed and validated to enhance prognostic accuracy in melanoma.” The authors determined that the 31-GEP test should be used to guide management in melanoma tumors that are equal to or greater than 0.3 millimeters thick.

SKIN: The Journal of Cutaneous Medicine® is a peer-reviewed online medical journal that is the official journal of The National Society for Cutaneous Medicine. The mission of SKIN is to provide an enhanced and accelerated route to disseminate new dermatologic knowledge for all aspects of cutaneous disease.

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Link to article

(DOI: 10.25251/skin.3.3.2)

Etan Marks, DO
UT Southwestern Medical Center
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