Bartlett Edmund K, O'Donoghue Cristina, Boland Genevieve, Bowles Tawnya, Delman Keith A, Hieken Tina J, Moncrieff Marc, Wong Sandra, White Richard L, Karakousis Giorgos
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
University of Chicago, Chicago, IL, USA.
Ann Surg Oncol. 2025 Mar;32(3):1429-1442. doi: 10.1245/s10434-024-16379-2. Epub 2024 Oct 29.
Gene expression profiling (GEP) of primary cutaneous melanoma aims to offer prognostic and predictive information to guide clinical care. Despite limited evidence of clinical utility, these tests are increasingly incorporated into clinical care.
A panel of melanoma experts from the Society of Surgical Oncology convened to develop recommendations regarding the use of GEP to guide management of patients with melanoma. The use of currently available GEP tests were evaluated in three clinical scenarios: (1) the utility in patient selection for sentinel lymph node biopsy; (2) the utility to guide surveillance; and (3) the utility to inform adjuvant therapy. As a basis for these recommendations, the panel performed a systematic review of the literature, including articles published from January 2012 until August 2023.
After review of 137 articles, 50 met the inclusion criteria. These articles included evidence related to three available GEP tests: 31-GEP, CP-GEP, and 11-GEP. The consensus recommendations were finalized using a modified Delphi process. The panel found that current evidence often fails to account for known clinicopathologic risk factors and lacks high-level data. The panel recognizes that the study of GEP tests is still evolving. The integration of GEP into routine clinical practice for predicting sentinel lymph node status and patient prognosis in melanoma is therefore not currently recommended.
At present, GEP should be considered primarily an investigational tool, ideally used in the context of clinical trials or specialized research settings.
原发性皮肤黑色素瘤的基因表达谱分析（GEP）旨在提供预后和预测信息以指导临床治疗。尽管临床效用的证据有限，但这些检测正越来越多地被纳入临床治疗中。
外科肿瘤学会的一组黑色素瘤专家召开会议，制定关于使用GEP指导黑色素瘤患者管理的建议。在三种临床场景中评估了当前可用的GEP检测的使用情况：（1）在哨位淋巴结活检的患者选择中的效用；（2）指导监测的效用；（3）辅助治疗的效用依据。作为这些建议的基础，该小组对文献进行了系统回顾，包括2012年1月至2023年8月发表的文章。
在审查了137篇文章后，50篇符合纳入标准。这些文章包括与三种可用的GEP检测相关的证据：31-GEP、CP-GEP和11-GEP。共识建议通过改良的德尔菲法最终确定。该小组发现，当前证据往往未能考虑已知的临床病理风险因素，且缺乏高级别数据。该小组认识到GEP检测的研究仍在不断发展。因此，目前不建议将GEP纳入常规临床实践以预测黑色素瘤的哨位淋巴结状态和患者预后。
目前，GEP应主要被视为一种研究工具，理想情况下应在临床试验或专门的研究环境中使用。
