Abstract 3615
Background
As primary cutaneous melanoma patients with a positive sentinel lymph node (SLN, stage III) are now considered candidates for adjuvant systemic therapy, a SLN biopsy (SLNB) is indicated in more patients. However, SLNB is an invasive procedure and is negative in approximately 80% of patients. Therefore, there is a need for a non-invasive test to accurately identify patients with primary cutaneous melanoma without nodal metastases. Here we describe the first independent validation of a recently developed CP-GEP model to predict nodal metastasis. This risk model combines Breslow thickness, age, and gene expression variables from the primary melanoma.
Methods
This study focused on all patients >18 years who underwent a SLNB at the Erasmus Medical Center (between January 2007 and December 2017), within 90 days after diagnosis of primary cutaneous melanoma. Total RNA was extracted from formalin-fixed paraffin-embedded (FFPE) primary cutaneous melanomas, reversed transcribed into cDNA and subsequently analyzed for the expression of 8 target genes involved in melanoma metastasis (ITGB3, PLAT, SERPINE2, GDF15, TGFBR1, LOXL4, IL8, MLANA) using an optimized qPCR protocol.
Results
FFPE tissue samples from 211 patients were analyzed using the CP-GEP model. At diagnosis, the median age was 55 years (interquartile range [IQR] 45-65), and the median Breslow thickness was 2.1mm (IQR 1.4-3.4). Most patients presented with a T2 or T3 melanoma, accounting for 94 and 70 patients, respectively. Overall, 27.5% of patients had a positive SLN. The CP-GEP model had a negative predictive value (NPV) of 89.4%. In patients with stage T1-T2 melanoma, the model was able to achieve an SLNB reduction rate of 40.1% with an NPV of 90.7%.
Conclusions
The CP-GEP model is a non-invasive and validated tool that is able to predict nodal metastasis in an independent Dutch population. Consequently, this risk model is able to accurately identify patients with primary cutaneous melanoma that can safely forego SLNB. Therefore, the CP-GEP model is a promising tool for patient care, preventing unnecessary surgery in the majority of patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Erasmus University Medical Center, Department of Dermatology.
Funding
SkylineDx.
Disclosure
J.T. Dwarkasing: Shareholder / Stockholder / Stock options, Full / Part-time employment: SkylineDx BV. D. Tempel: Shareholder / Stockholder / Stock options, Full / Part-time employment: SkylineDx BV. L. Bosman: Shareholder / Stockholder / Stock options, Full / Part-time employment: SkylineDx. A.A.M. Van der Veldt: Advisory / Consultancy: BMS; Advisory / Consultancy: MSD; Advisory / Consultancy: Roche; Advisory / Consultancy: Novartis; Advisory / Consultancy: Pierre Fabre; Advisory / Consultancy: Pfizer; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Ipsen. All other authors have declared no conflicts of interest.
Resources from the same session
3117 - A modified Edmonton Symptom Assessment Scale for assessing symptoms in one day chemotherapy clinic
Presenter: Anjuleta Kampitsi
Session: Poster Display session 3
Resources:
Abstract
6058 - Level of physical activity and nutritional status in cancer patients with fatigue: an exploratory cross-sectional study
Presenter: Patrick Jahn
Session: Poster Display session 3
Resources:
Abstract
1980 - Catheter related necrotizing fascitiis in haematological patients. Case report and implications for nursing
Presenter: Arianna Rosich Soteras
Session: Poster Display session 3
Resources:
Abstract
3984 - Everyday life with Long-term Chemotherapy Induced Peripheral Neuropathy among Patient in Adjuvant Treatment for Colorectal Cancer – a Multi Methods Study
Presenter: Marlene Jensen
Session: Poster Display session 3
Resources:
Abstract
2202 - Scalp cooler is effective in reducing chemotherapy-induced alopecia among breast cancer patients : a single institution experience
Presenter: Emilia Gianotti
Session: Poster Display session 3
Resources:
Abstract
5942 - Nursing management of fatigue in cancer patients: mixed methods study
Presenter: Angela Tolotti
Session: Poster Display session 3
Resources:
Abstract
2930 - Awareness of Nursing Students about the Warning Signs of Cancer
Presenter: Hatice Yakar
Session: Poster Display session 3
Resources:
Abstract
2978 - Assessment of quality of life in patients with cancer and diabetes 2 in Northern Greece.
Presenter: STYLIANI MICHALOPOULOU
Session: Poster Display session 3
Resources:
Abstract
3400 - Radiation dose variables related to the causes of skin toxicities in women with breast cancer: a study proposal
Presenter: EULALIA PUJOL
Session: Poster Display session 3
Resources:
Abstract
2156 - How should the symptoms be managed after breast cancer surgery? An example of mobile app
Presenter: AYDANUR AYDIN
Session: Poster Display session 3
Resources:
Abstract