Genetic test predicts melanoma recurrence risk

A new genetic test can identify patients with nonmetastatic melanoma who are at high risk of recurrence, according to validation data presented at the 2013 summer meeting of the American Academy of Dermatology.

Using the DecisionDx-Melanoma test (Castle Biosciences), researchers with Northwestern Skin Cancer Institute, Northwestern University, Chicago, measured gene expression profiles of archived formalin-fixed, paraffin-embedded biopsies or wide excisions of primary melanoma tumors from 78 patients with stage 1 and stage 2 melanoma, according to a news release.

The DecisionDx-Melanoma test measures the expression levels of 31 genes in tumors and stratifies patients as either class 1 (low risk of metastasis) or class 2 (high risk of metastasis), based on which tumor genes are turned on and off. To date, the test has analyzed archived tumor samples from more than 400 patients with stage 1 and stage 2 melanoma.

Data from the latest study confirmed the test accurately stratifies metastatic risk for these patients, according to researchers. Investigators found that five-year metastasis free survival rates were 98 percent for class 1 and 37 percent for class 2 (P<0.0001), according to Kaplan-Meier analysis (accuracy = 85 percent, sensitivity = 86 percent). Cox proportional multivariate analysis found the test to be independent of Breslow, mitosis and ulceration as well as AJCC stage (p<0.01).

“The availability of a tool that helps predict future cancer behavior based on the tumor’s biology, independent of and additive to current staging methods, is a welcomed advance,” said study presenter Pedram Gerami, M.D., associate professor of dermatology at Northwestern University.

The study has not been published in a peer-reviewed journal.

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