A clinical impact study of dermatologists' use of diagnostic gene expression profile testing to guide patient management.

IF 1 Q4 ONCOLOGY Melanoma Management Pub Date : 2024-05-09 eCollection Date: 2024-01-01 DOI:10.2217/mmt-2023-0002

Alexander Witkowski, Abel D Jarell, Kelli L Ahmed, Jennifer J Siegel, Brooke H Russell, Jason H Rogers, Matthew S Goldberg, Neil F Fernandes, Joanna Ludzik, Aaron S Farberg

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Abstract

Aim: Cutaneous melanocytic neoplasms with diagnostic and/or clinical ambiguity pose patient management challenges. Methods: Six randomized case scenarios with diagnostic/clinical uncertainty were described with/without a benign or malignant diagnostic gene expression profile (GEP) result. Results: Clinical impact was assessed by reporting the mean increase/decrease of management changes normalized to baseline (n = 32 dermatologists). Benign GEP results prompted clinicians to decrease surgical margins (84.2%). Malignant GEP results escalated surgical excision recommendations (100%). A majority (72.2%) reduced and nearly all (98.9%) increased follow-up frequency for benign or malignant GEP results, respectively. There was an overall increase in management plan confidence with GEP results. Conclusion: Diagnostic GEP tests help guide clinical decision-making in a variety of diagnostically ambiguous or clinicopathologically discordant scenarios.

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皮肤科医生使用基因表达谱诊断测试指导患者管理的临床影响研究。

目的：诊断和/或临床不明确的皮肤黑色素细胞肿瘤给患者管理带来了挑战。方法：描述了六个诊断/临床不确定的随机病例，其中有/没有良性或恶性基因表达谱（GEP）诊断结果。结果：通过报告与基线正常化后的管理变化的平均增加/减少来评估临床影响（n = 32 名皮肤科医生）。良性 GEP 结果促使临床医生缩小手术切缘（84.2%）。恶性 GEP 结果使手术切除建议升级（100%）。大多数（72.2%）和几乎所有（98.9%）的临床医生分别减少了良性或恶性 GEP 结果的随访次数。随着 GEP 结果的出现，对治疗方案的信心总体上有所增强。结论：诊断性 GEP 检测有助于在各种诊断不明确或临床病理不一致的情况下指导临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Melanoma Management ONCOLOGY-

CiteScore

5.10

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： Skin cancer is on the rise. According to the World Health Organization, 132,000 melanoma skin cancers occur globally each year. While early-stage melanoma is usually relatively easy to treat, once disease spreads prognosis worsens considerably. Therefore, research into combating advanced-stage melanoma is a high priority. New and emerging therapies, such as monoclonal antibodies, B-RAF and KIT inhibitors, antiangiogenic agents and novel chemotherapy approaches hold promise for prolonging survival, but the search for a cure is ongoing. Melanoma Management publishes high-quality peer-reviewed articles on all aspects of melanoma, from prevention to diagnosis and from treatment of early-stage disease to late-stage melanoma and metastasis. The journal presents the latest research findings in melanoma research and treatment, together with authoritative reviews, cutting-edge editorials and perspectives that highlight hot topics and controversy in the field. Independent drug evaluations assess newly approved medications and their role in clinical practice. Key topics covered include: Risk factors, prevention and sun safety education Diagnosis, staging and grading Surgical excision of melanoma lesions Sentinel lymph node biopsy Biological therapies, including immunotherapy and vaccination Novel chemotherapy options Treatment of metastasis Prevention of recurrence Patient care and quality of life.