Assessment of the 31-Gene Expression Profile Test by Dermatologists: A Cross-Sectional Survey from National Dermatology Conferences

Abstract

Background: The 31-gene expression profile (31-GEP) test uses 31 genetic markers obtained from the initial biopsy of a melanoma to assess melanoma-specific survival and sentinel lymph node positivity. Objective: To assess the professional understanding, opinions, and clinical usage of the 31-GEP test by dermatologists. Methods: Data from 589 unique dermatologists were collected during 2 virtual, nation-wide dermatology conferences via an 18-question survey on practice demographics and their clinical use and opinion of the 31-GEP test. Results: Participants reported that integrating the 31-GEP test may benefit patients by increasing knowledge and understanding (72.5%), personalizing treatment options (58.8%), and easing uncertainty about the future (59.7%). Benefits of using the 31-GEP test included identifying true negative patients in high-risk populations (65.6%) as well as true positives in low-risk populations (70.6%).A majority of participants also noted that if a patient received a 31-GEP Class 2B result, they would escalate subsequent management even if the lesions were classified as T1 (61.4%) or AJCC8 Stage I (59.0%). 84.9% of participants were somewhat to very likely to use 31-GEP testing for patient management or recommend this test to a colleague. Limitations: Potential respondent-selection and recall bias. Conclusion: Dermatologists are increasingly integrating the 31-GEP test into their melanoma clinical management decisions. As the 31-GEP test becomes more prevalent in practice, patients may benefit from decreased anxiety and uncertainty from enhanced prognosis, decreased need for unwarranted procedures such as sentinel lymph node biopsy and optimized allocation of healthcare resources.

Clinical Utility of the 31-Gene Expression Profile Test on the Management of Cutaneous Melanoma by Nurse Practitioners and Physician Assistants

“…The providers participating in our study report that prognostic information for CM allows them to make more informed treatment planning decisions, such as follow-up schedules and referrals for SLNB. These positions are echoed by physicians, as previously published survey results of dermatologists, medical oncologists, and surgical oncologists indicated similar viewpoints about prognostic testing and its utility in their clinical practices ( Marson et al, 2021 ). Additionally, most NPs and PAs, even those who did not report current use of 31-GEP testing, would recommend prognostic testing to their colleague or to someone they know if they were diagnosed with CM.…”

Attitudes of patients with cutaneous melanoma toward prognostic testing using the 31‐gene expression profile test

“…The 31‐GEP test is a validated prognostic tool for treatment and surveillance planning for patients with CM. 27 , 28 , 29 , 30 , 31 The majority of patients diagnosed with AJCC Stage I or II tumors have very good outcomes; however, some of these patients will experience recurrence and metastasis. 2 , 3 The 31‐GEP test accurately predicts the risk of recurrence independently from and in combination with AJCC staging, showing that it complements traditional clinicopathologic factors.…”