Prognostic gene expression profile testing to inform use of adjuvant therapy: A survey of melanoma experts

Cancer Med. 2023 Dec;12(24):22103-22108. doi: 10.1002/cam4.6819. Epub 2023 Dec 14.

Abstract

Objectives: To investigate current practices and attitudes regarding use of adjuvant immunotherapy and prognostic gene expression profile (GEP) testing among melanoma medical and surgical oncologists.

Methods: An anonymous RedCap-based survey was emailed to ~300 melanoma experts.

Results: Respondents generally favored adjuvant immunotherapy over observation (73% for all Stage IIIA, 50% for Stage IIB/IIC) and cited a minimum 10-year recurrence risk of 11%-20% (48%) or 21%-30% (33%) to justify treatment, but acknowledged that risks of serious adverse events may outweigh potential benefits for some Stage IIB/IIC patients. While GEP test results did not strongly influence decision-making regarding follow-up or intervention, most were receptive to randomized trials using GEP testing to identify subsets of Stage IIB/IIC (74%) and Stage IB/IIA (54%) patients who may not or may, respectively, benefit from adjuvant therapy.

Conclusion: Although most respondents do not routinely use GEP testing, many would participate in clinical trials to determine clinical utility.

Keywords: adjuvant therapy; clinical trial; gene expression profiling; melanoma.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Gene Expression Profiling / methods
  • Humans
  • Melanoma* / genetics
  • Melanoma* / pathology
  • Melanoma* / therapy
  • Neoplasm Staging
  • Prognosis
  • Skin Neoplasms* / pathology
  • Surveys and Questionnaires
  • Transcriptome