Identification of stage I/IIA melanoma patients at high risk for disease relapse using a clinicopathologic and gene expression model

Alexander M.M. Eggermont, Domenico Bellomo, Suzette M. Arias-Mejias, Enrica Quattrocchi, Sindhuja Sominidi-Damodaran, Alina G. Bridges, Julia S. Lehman, Tina J. Hieken, James W. Jakub, Dennis H. Murphree, Mark R. Pittelkow, Jason C. Sluzevich, Mark A. Cappel, Sanjay P. Bagaria, Charles Perniciaro, Félicia J. Tjien-Fooh, Barbara Rentroia-Pacheco, Renske Wever, Martin H. van Vliet, Jvalini DwarkasingAlexander Meves

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Patients with stage I/IIA cutaneous melanoma (CM) are currently not eligible for adjuvant therapies despite uncertainty in relapse risk. Here, we studied the ability of a recently developed model which combines clinicopathologic and gene expression variables (CP-GEP) to identify stage I/IIA melanoma patients who have a high risk for disease relapse. Patients and methods: Archival specimens from a cohort of 837 consecutive primary CMs were used for assessing the prognostic performance of CP-GEP. The CP-GEP model combines Breslow thickness and patient age, with the expression of eight genes in the primary tumour. Our specific patient group, represented by 580 stage I/IIA patients, was stratified based on their risk of relapse: CP-GEP High Risk and CP-GEP Low Risk. The main clinical end-point of this study was five-year relapse-free survival (RFS). Results: Within the stage I/IIA melanoma group, CP-GEP identified a high-risk patient group (47% of total stage I/IIA patients) which had a considerably worse five-year RFS than the low-risk patient group; 74% (95% confidence interval [CI]: 67%–80%) versus 89% (95% CI: 84%–93%); hazard ratio [HR] = 2.98 (95% CI: 1.78–4.98); P < 0.0001. Of patients in the high-risk group, those who relapsed were most likely to do so within the first 3 years. Conclusion: The CP-GEP model can be used to identify stage I/IIA patients who have a high risk for disease relapse. These patients may benefit from adjuvant therapy.

Original languageEnglish (US)
Pages (from-to)11-18
Number of pages8
JournalEuropean Journal of Cancer
Volume140
DOIs
StatePublished - Nov 2020

Keywords

  • CP-GEP
  • Clinicopathologic
  • Gene expression variables
  • Metastasis
  • Primary cutaneous melanoma
  • Prognostic biomarkers
  • Relapse-free survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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