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

Author:

Fastner Suzanne1,Shen Nathan1,Hartman Rebecca I.234,Chu Emily Y.5,Kim Caroline C.6,Kirkwood John M.78,Grossman Douglas12ORCID

Affiliation:

1. Huntsman Cancer Institute University of Utah Health Sciences Center Salt Lake City Utah USA

2. Department of Dermatology University of Utah Health Sciences Center Salt Lake City Utah USA

3. Department of Dermatology Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts USA

4. Department of Dermatology VA Integrated Service Network (VISN‐1) Jamaica Plain Massachusetts USA

5. Department of Dermatology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA

6. Department of Dermatology Tufts Medical Center Boston Massachusetts USA

7. Departments of Dermatology University of Pittsburgh, UPMC Hillman Cancer Center Pittsburgh Pennsylvania USA

8. Departments of Medicine University of Pittsburgh, UPMC Hillman Cancer Center Pittsburgh Pennsylvania USA

Abstract

AbstractObjectivesTo investigate current practices and attitudes regarding use of adjuvant immunotherapy and prognostic gene expression profile (GEP) testing among melanoma medical and surgical oncologists.MethodsAn anonymous RedCap‐based survey was emailed to ~300 melanoma experts.ResultsRespondents 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.ConclusionAlthough most respondents do not routinely use GEP testing, many would participate in clinical trials to determine clinical utility.

Funder

University of Utah

Huntsman Cancer Foundation

U.S. Department of Defense

Publisher

Wiley

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology

Reference13 articles.

1. Adjuvant Pembrolizumab versus Placebo in Resected Stage III Melanoma

2. Pembrolizumab versus placebo as adjuvant therapy in completely resected stage IIB or IIC melanoma (KEYNOTE-716): a randomised, double-blind, phase 3 trial

3. Prognostic Gene Expression Profiling in Cutaneous Melanoma

4. release CBp.2023.https://ir.castlebiosciences.com/news/news‐details/2023/Castle‐Biosciences‐Reports‐Fourth‐Quarter‐and‐Full‐Year‐2022‐Results/default.aspx

5. V.2.2023 NGfCM.2023.https://www.nccn.org/guidelines/category_1

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