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Expert Consensus-Based Appropriate Use Criteria Recommendations for Genomic Tests in Melanoma Patients are Now Available

Despite the widespread incorporation of these tests into melanoma patient management, no specific guidelines for appropriate usage existed prior to this study.”
— Graham Litchman, DO
NEW YORK, NEW YORK, UNITED STATES, September 17, 2019 / -- SKIN: The Journal of Cutaneous Medicine®
Article: Clinical Management Recommendations: Appropriate Use Criteria for the Integration of Diagnostic and Prognostic Gene Expression Profile Assays into the Management of Cutaneous Malignant Melanoma: An Expert Panel Consensus-Based Modified Delphi Process Assessment

Skin cancer continues to be the most common cancer in the United States and worldwide. In fact, the incidence of malignant melanoma, the most dangerous type of skin cancer, has increased dramatically over the last century. Gene Expression Profiling (GEP) is a technique that uses the genetic pattern of tumors to help determine the best way to manage patients with cancer. GEP technology has recently become readily available to help better assess diagnosis, prognosis, and subsequent management of malignant melanoma in patients with this cancer.

The authors note that GEP assays determine the level of expression of key genes that vary between benign and malignant melanomas and explain how important distinction can ascertain lower vs higher propensities for metastasis. Furthermore, results from these specific tests can aid in the decision to biopsy difficult to diagnose lesions and provide managing clinicians with prognostic insight in cases of biopsy-proven melanoma.

Dr. Litchman relates there are currently 3 GEP tests (2-GEP, 23-GEP, 31-GEP), all of which are validated, CLIA-certified, and FDA-approved, and were incorporated in melanoma management over 10,000 times in the United States in the last year. Despite the widespread incorporation of these tests into melanoma patient management, no specific guidelines for appropriate usage existed prior to this study. A renowned group of experts was assembled to engage in meaningful discussion about relevant indications for these tests to help clinicians maintain best practices for their patients.

The expert panel was tasked to review a broad selection of clinical scenarios commonly faced by practicing dermatologic surgeons and dermatopathologists in the diagnosis and management of melanocytic lesions. The panel employed Strength of Recommendation Taxonomy (SORT) methodology during deliberation and ultimately reached a consensus that they believed would yield the most benefit to both patients and practitioners. Litchman and the GEP expert panel hope that these Appropriate Use Guidelines will help for better selective usage of these tests and lead to better outcomes for melanoma patients.

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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(DOI: 10.25251/skin.3.5.1)

Graham Litchman
National Society for Cutaneous Medicine
+1 212-684-5964
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