31-Gene Expression Profile Testing in Cutaneous Melanoma and Survival Outcomes in a Population-Based Analysis: A SEER Collaboration

• Type of Material: Article
• Authors: Christine N Bailey, Castle Biosciences; Brian J Martin, Castle Biosciences; Valentina I Petkov, National Cancer Institute; Nicola C Schussler, Information Management Systems; Jennifer L Stevens, Information Management Systems; Suzanne Bentler, The University of Iowa; Rosemary D Cress, Cancer Registry of Greater California; Jennifer A Doherty, University of Utah; Eric B Durbin, University of Kentucky; Scarlett L Gomez, University of California, San Francisco, California; Lou Gonsalves, Connecticut Department of Public Health; Brenda Y Hernandez, University of Hawaii; Lihua Liu, University of Southern California, Los Angeles, California; Bożena M Morawski, Cancer Data Registry of Idaho; Maria J Schymura, State University of New York, New York City, New York; Stephen M Schwartz, Fred Hutchinson Cancer Center; Kevin C. Ward, Emory University; Charles Wiggins, University of New Mexico, Albuquerque, New Mexico; Xiao-Cheng Wu, Louisiana State University; Matthew S Goldberg, Icahn School of Medicine at Mount Sinai; Jennifer J Siegel, Castle Biosciences; Robert W Cook, Castle Biosciencesc; Kyle R Covington, Castle Biosciences; Sarah J Kurley, Castle Biosciences
• Language: English
• Date: 2023-06-29
• Publisher: American Society of Clinical Oncology
• Publication Version: Final Published Version
• Copyright Statement: © 2023 by American Society of Clinical Oncology
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1200%2FPO.23.00044
• Title of Journal or Parent Work: JCO Precision Oncology
• Volume: 7
• Start Page: e2300044
• Grant/Funding Information: S.L.G.: University of California, San Francisco, CA through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN261201800032I.; M.J.S.: Bureau of Cancer Epidemiology, New York State Department of Health, Albany, NY through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN261201800005I and Centers for Disease Control and Prevention NU58DP006309; X.W.: School of Public Health Louisiana State University Health New Orleans, through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN261201800007I/HHSN26100002; S.M.S.: Division of Public Health Sciences Fred Hutchinson Cancer Center, through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN2612018000041.; E.B.D.: Kentucky Cancer Registry, through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award No. HHSN261201800013I.; C.W.: Emory University, Atlanta, GA, through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN261201800014I; K.C.W.: Emory University, Atlanta GA. through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN261201800003I and Centers for Disease Control and Prevention 6NU58DP006352-05-01.; R.D.C.: Public Health Institute, Cancer Registry of Greater California, through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award No. HHSN261201800009I.; S.B.: Iowa Cancer Registry, through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award No. HHSN261201800012I_HHSN26100001; B.M.M.: Cancer Data Registry of Idaho, Idaho Hospital Association, Boise, Idaho through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN261201800006I and Centers for Disease Control and Prevention 1NU58DP006270.; L.L.: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN261201800032I.; B.Y.H.: University of Hawaii Cancer Center, HI through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN261201300009I.; L.G.: The Connecticut Tumor Registry is supported by Federal funds from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services, under Contract no. HHSN261201800002I.; J.A.D.: HCI Cancer Control and Population Sciences Program, through National Cancer Institute, Surveillance, Epidemiology and End Results Program Contract Award HHSN261201800016I.
• Keywords: 31-gene; melanoma; SEER Program; gene expression profiling; prognosis
• Research Categories: Biology, Genetics; Health Sciences, Oncology

Abstract

PURPOSE: The DecisionDx-Melanoma 31-gene expression profile (31-GEP) test is validated to classify cutaneous malignant melanoma (CM) patient risk of recurrence, metastasis, or death as low (class 1A), intermediate (class 1B/2A), or high (class 2B). This study aimed to examine the effect of 31-GEP testing on survival outcomes and confirm the prognostic ability of the 31-GEP at the population level. METHODS: Patients with stage I-III CM with a clinical 31-GEP result between 2016 and 2018 were linked to data from 17 SEER registries (n = 4,687) following registries' operation procedures for linkages. Melanoma-specific survival (MSS) and overall survival (OS) differences by 31-GEP risk category were examined using Kaplan-Meier analysis and the log-rank test. Crude and adjusted hazard ratios (HRs) were calculated using Cox regression model to evaluate variables associated with survival. 31-GEP tested patients were propensity score–matched to a cohort of non–31-GEP tested patients from the SEER database. Robustness of the effect of 31-GEP testing was assessed using resampling. RESULTS: Patients with a 31-GEP class 1A result had higher 3-year MSS and OS than patients with a class 1B/2A or class 2B result (MSS: 99.7% v 97.1% v 89.6%, P < .001; OS: 96.6% v 90.2% v 79.4%, P < .001). A class 2B result was an independent predictor of MSS (HR, 7.00; 95% CI, 2.70 to 18.00) and OS (HR, 2.39; 95% CI, 1.54 to 3.70). 31-GEP testing was associated with a 29% lower MSS mortality (HR, 0.71; 95% CI, 0.53 to 0.94) and 17% lower overall mortality (HR, 0.83; 95% CI, 0.70 to 0.99) relative to untested patients. CONCLUSION: In a population-based, clinically tested melanoma cohort, the 31-GEP stratified patients by their risk of dying from melanoma. Patients clinically tested with the 31-GEP had higher melanoma-specific survival relative to untested patients.