Guidance of sentinel lymph node biopsy decisions in patients with T1-T2 melanoma using gene expression profiling

Future Oncol. 2019 Apr;15(11):1207-1217. doi: 10.2217/fon-2018-0912. Epub 2019 Jan 29.

Abstract

Aim: Can gene expression profiling be used to identify patients with T1-T2 melanoma at low risk for sentinel lymph node (SLN) positivity?

Patients & methods: Bioinformatics modeling determined a population in which a 31-gene expression profile test predicted <5% SLN positivity. Multicenter, prospectively-tested (n = 1421) and retrospective (n = 690) cohorts were used for validation and outcomes, respectively.

Results: Patients 55-64 years and ≥65 years with a class 1A (low-risk) profile had SLN positivity rates of 4.9% and 1.6%. Class 2B (high-risk) patients had SLN positivity rates of 30.8% and 11.9%. Melanoma-specific survival was 99.3% for patients ≥55 years with class 1A, T1-T2 tumors and 55.0% for class 2B, SLN-positive, T1-T2 tumors.

Conclusion: The 31-gene expression profile test identifies patients who could potentially avoid SLN biopsy.

Keywords: biomarker; gene expression profiling; melanoma; prognosis; sentinel lymph node biopsy.

MeSH terms

  • Adolescent
  • Aged, 80 and over
  • Clinical Decision-Making
  • Gene Expression Profiling*
  • Humans
  • Lymphatic Metastasis
  • Melanoma / diagnosis*
  • Melanoma / genetics*
  • Melanoma / mortality
  • Neoplasm Staging
  • Prognosis
  • Sentinel Lymph Node / pathology
  • Sentinel Lymph Node Biopsy
  • Transcriptome*