Correlation of Gene Expression Profile Status and American Joint Commission on Cancer Stage in Uveal Melanoma

Berry, D. H.; Schefler, Amy C; Seider, Michael I.; Materin, Miguel A.; Stinnett, Sandra S.; Mruthyunjaya, Prithvi

doi:10.1097/iae.0000000000002385

Cited by 13 publications

(9 citation statements)

References 41 publications

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“…There is a documented discordance between clinical cancer staging and molecular prognostic results [8]. We observed that 80% of AJCC stage III melanomas were GEP class 2 and half of AJCC stage I and II melanomas were GEP class 1A.…”

Section: Discussionmentioning

confidence: 77%

“…Prognostic information such as the GEP has been shown to alter the surveillance strategies and referral patterns of physicians caring for patients with UM [7]. While it has been shown that higher risk GEP class and higher risk AJCC cancer stage are often correlated at presentation [8], the prognostic outcomes of the 2 entities are not always in agreement. When discordant, it becomes challenging to determine an appropriate surveillance strategy.…”

Section: Introductionmentioning

confidence: 99%

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Improved Prognostic Precision in Uveal Melanoma through a Combined Score of Clinical Stage and Molecular Prognostication

2021

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Introduction: Prognosis of uveal melanoma (UM) is assessed using clinical staging or molecular testing. Two modalities often used for prognostication are the American Joint Committee on Cancer (AJCC) staging and a tumor gene expression profile (GEP), the outcomes of which are often discordant. This paper discusses a Total Risk Score created to combine the discordant information from both sources. Methods: A retrospective case series was conducted of all patients presenting with UM over six years to two referral centers. Each tumor was classified using the AJCC and the GEP. A Total Risk Score was calculated for each patient using results from both AJCC and GEP. Kaplan-Meier analysis of metastasis free-survival was used to compare groups. Results: A total of 294 patients were included in the study. Kaplan-Meier estimates showed significant curve separation between individual AJCC and GEP risk groups. The combined Total Risk Score provided an accurate estimate of prognosis that incorporated results from both AJCC and GEP. Conclusions: Clinical staging and molecular prognostication of UM can be discordant. There is important information provided by each system that is not provided by the other. The Total Risk Score provides a simple method to combine information from both the AJCC stage and the GEP class in order to provide patients and care teams with a more complete understanding of metastatic risk.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Improved Prognostic Precision in Uveal Melanoma through a Combined Score of Clinical Stage and Molecular Prognostication

2021

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“…Berry et al . stratified 360 melanoma patients into AJCC stages 1, 2, and 3 as well as GEP class and discovered that there was a significant correlation between larger tumor dimensions (both LBD and thickness) and class 2 status ( P <0.05) 144 . Moreover, larger AJCC tumor groups had a significantly higher odds ratio of having a worse prognosis based on the corresponding GEP class.…”

Section: Uveal Melanomamentioning

confidence: 99%

Recent advancements in the management of retinoblastoma and uveal melanoma

Schefler¹,

Kim

2021

Fac Rev

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Retinoblastoma in children and uveal melanoma in adults can pose a serious threat to both vision and life. For many decades, enucleation was often the only option to treat these intraocular malignancies. For retinoblastoma, intra-arterial chemotherapy is often utilized as the primary treatment at advanced academic centers and has dramatically improved local tumor control and eye salvage rates. For uveal melanoma, both plaque brachytherapy and proton beam irradiation have served as widely utilized therapies with a local failure rate of approximately 1–10%, depending on the series. Major recent advancements have allowed for a better understanding of the genomics of uveal melanoma and the impact of certain mutations on metastatic susceptibility. Gene expression profile stratifies uveal melanomas into two classes: low-risk (class 1) and high-risk (class 2). A loss-of-function mutation of BAP1 is associated with a class 2 gene expression profile and therefore confers worse prognosis due to elevated risk of metastasis. On the other hand, gain-of-function mutations of EIF1AX and SF3B1 correspond to a gene expression profile of class 1A and class 1B and confer a better prognosis. Preferentially expressed antigen in melanoma (PRAME) is an antigen that increases metastatic susceptibility when expressed in uveal melanoma cells. In addition to plaque brachytherapy and proton beam irradiation, both of which have demonstrated superb clinical outcomes, scientists are actively investigating newer therapeutic modalities as either primary therapy or adjuvant treatment, including a novel nanoparticle therapy and immunotherapy.

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“…GEP allows for the classification of primary uveal melanomas into Class 1A (low metastatic risk), Class 1B (intermediate risk) and Class 2 (high risk) [19,20]. We have previously demonstrated that Class 1 tumors respond faster to radiation therapy as seen by a decrease in tumor height, described practice patterns with regard to tumor biopsy technique, and correlated GEP with American Joint Commission on Cancer Staging [21,22]. Here we report practice patterns for patients treated for uveal melanoma with I-125 plaque brachytherapy who concurrently underwent fine-needle aspirate biopsy for GEP testing of the melanoma, as well as current practice patterns at OOSC institutions as determined by a 2018 survey.…”

Section: Introductionmentioning

confidence: 99%

Practice Patterns for the Treatment of Uveal Melanoma with Iodine-125 Plaque Brachytherapy: Ocular Oncology Study Consortium Report 5

et al. 2019

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Background: Treatment planning for I-125 plaque therapy for uveal melanoma has advanced significantly since the Collaborative Ocular Melanoma Study trial, with more widely available image-guided planning and improved dosimetry. Objective: We evaluated real-world practice patterns for I-125 plaque brachytherapy in the United States by studying practice patterns at centers that comprise the Ocular Oncology Study Consortium (OOSC). Methods: The OOSC database and responses to a treatment practice survey were eval-I-125 Plaque Brachytherapy Clinical Practices 211practices was high among OOSC institutions. Clinical margins and planning systems were similar among institutions, while prescription dose, dose rates, and dosimetry varied.

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Correlation of Gene Expression Profile Status and American Joint Commission on Cancer Stage in Uveal Melanoma

Cited by 13 publications

References 41 publications

Improved Prognostic Precision in Uveal Melanoma through a Combined Score of Clinical Stage and Molecular Prognostication

Improved Prognostic Precision in Uveal Melanoma through a Combined Score of Clinical Stage and Molecular Prognostication

Recent advancements in the management of retinoblastoma and uveal melanoma

Practice Patterns for the Treatment of Uveal Melanoma with Iodine-125 Plaque Brachytherapy: Ocular Oncology Study Consortium Report 5

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