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Detecting Thin Melanoma
Although the risk of relapse of patients with thin melanoma is regraded low, a significant and steadily increasing proportion of early-stage cutaneous melanoma patients relapse and die of their melanoma. In fact, 25 percent of mortality is caused by cutaneous melanomas smaller than 1 millimetre in thickness. These high-risk patients cannot be detected, so far, by conventional prognostic methods.
At the 9th World Congress of Melanoma and 14th International Congress of the Society for Melanoma Research, a team of German scientists presented research to address this problem. They had previously identified a prognostic gene signature expressed in cutaneous melanoma and adjacent stroma. A validated signature-based gene expression risk score predicts patient survival and need for adjuvant therapy.
The team performed an exploratory study to evaluate the ability of gene expression risk score to identify thin melanoma at the time of first diagnosis.
The study analysed 345 cutaneous melanomas. The median follow-up time was 6.25 years, and five-year relapse-free survival was used as a clinical endpoint.
Within the cohort of 98 thin melanomas, 17 events were observed. Seven (41 percent) of these high-risk patients were identified by a high gene expression risk score. More than half of the patients with a high gene expression risk score relapsed within five years following diagnosis.
Researchers concluded that the gene expression risk score is an independent, non-invasive predictor of relapse-free survival in cutaneous melanoma and defines high-risk patients in all stages. Part of the thin fatal cutaneous melanomas, which remain undetectable by conventional methods, can be identified by a high gene expression risk score.
They recommended that these high-risk patients need long-term intensified follow-up care, because early relapse detection increases survival probability of cutaneous melanoma patients.
Brunner, G. et al. (October 2017.) Identification of thin fatal melanomas, at first diagnosis, by a gene-signature based risk score. 9th World Congress of Melanoma and 14th International Congress of the Society for Melanoma Research. Retrieved from http://www.professionalabstracts.com/melanoma2017/Iplanner/#/presentation/324