Metastatic Risk Factors Associated with Class 1A Uveal Melanoma Patients

Ballhausen, Alexej; Urias, Elizabeth; Gruschkus, Stephen K.; Williams, Michelle D.; Glover, Maura S.; Qin, Yong; Gombos, Dan S.; Patel, Sapna

doi:10.3390/cancers13133292

Cited by 8 publications

(6 citation statements)

References 24 publications

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“…In contradiction to these predictions, our study showed a higher actuarial rate of metastasis in the GEP 1A subgroup than in the GEP 1B subgroup and a very low rate of metastasis in the GEP 1B cases. The metastatic rate we observed in our GEP 1A patients is similar to the rate reported by Ballhausen and coworkers in their GEP 1A patients [6].…”

Section: Discussion/conclusionsupporting

confidence: 92%

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Comparative Metastatic Rates in GEP Class 1A versus 1B Posterior Uveal Melanoma: Results Contrary to Expectations

2022

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Purpose: The purpose of this study was to determine whether the metastatic rates in patients with gene expression profile (GEP) class 1A versus 1B posterior uveal malignant melanoma supported or contradicted predictions of very low metastatic rate in GEP 1A cases and moderate rate in GEP 1B cases. Patients/Methods: 164 patients with a cytopathologically-confirmed primary posterior uveal malignant melanoma classified by GEP testing as class 1 (100 GEP 1A, 64 GEP 1B) were evaluated. Kaplan-Meier rates of metastasis were computed and plotted for the GEP class 1 subgroups. Median follow-up of patients who were still alive without metastasis on the date of data analysis was 100.5 months for the GEP 1A patients and 97.2 months for the GEP 1B patients. Results: The actuarial 5-year rate of uveal melanoma metastasis was 10.8% (std. error = 3.2%) in the GEP 1A patients versus 0% in the GEP 1B patients, and the actuarial 10-year rate of metastasis was 12.2% (std. error = 3.5%) in the GEP 1A patients versus 2.1% (std. error 2.1%) in the GEP 1B patients. Conclusion: The results of this retrospective single-center study cast doubt on the validity of the prognostic stratification of GEP class 1 posterior uveal malignant melanomas into very low risk (GEP 1A) versus intermediate risk (GEP 1B) of metastasis subgroups provided by the commercially available GEP test.

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Section: Discussion/conclusionsupporting

confidence: 92%

“…More recently, a separate group evaluated and reported the actuarial rate of metastasis in 73 patients with a GEP 1A UM in a single-center retrospective study [6]. The median follow-up time in this group was 37 months.…”

Section: Introductionmentioning

confidence: 99%

Comparative Metastatic Rates in GEP Class 1A versus 1B Posterior Uveal Melanoma: Results Contrary to Expectations

2022

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“…Cook and Alsina cite a report by Demirci and coworkers [5] (which we acknowledged and cited in our recent publication) that supports the expected separation of survival curves of GEP class 1A versus1B patients. These authors reported a similar number of cases as we did.…”

supporting

confidence: 58%

Response to Cook and Alsina’s Letter to Editor (Reply to Augsburger et al.)

Augsburger¹,

Skinner²,

Corrêa³

2023

Ocul Oncol Pathol

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“…Similarly, a 5-year metastatic rate of 17% was observed in a study of metastatic risk factors restricted to patients with class 1A tumors [21].…”

Section: Discussionmentioning

confidence: 65%

Impact of gene expression profiling on diagnosis and survival after metastasis in patients with uveal melanoma

Suwajanakorn,

Lane,

et al. 2024

Melanoma Research

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Surveillance frequency for metastasis is guided by gene expression profiling (GEP). This study evaluated the effect of GEP on time to diagnosis of metastasis, subsequent treatment and survival. A retrospective study was conducted of 110 uveal melanoma patients with GEP (DecisionDx-UM, Castle Biosciences, Friendswood, Texas, USA) and 110 American Joint Committee on Cancer-matched controls. Surveillance testing and treatment for metastasis were compared between the two groups and by GEP class. Rates of metastasis, overall survival and melanoma-related mortality were calculated using Kaplan–Meier estimates. Baseline characteristics and follow-up time were balanced in the two groups. Patients’ GEP classification was 1A in 41%, 1B in 25.5% and 2 in 33.6%. Metastasis was diagnosed in 26.4% (n = 29) in the GEP group and 23.6% (n = 26) in the no GEP group (P = 0.75). Median time to metastasis was 30.5 and 22.3 months in the GEP and no GEP groups, respectively (P = 0.44). Median months to metastasis were 34.7, 75.8 and 26.1 in class 1A, 1B and 2 patients, respectively (P = 0.28). Disease-specific 5-year survival rates were 89.4% [95% confidence interval (CI): 81.0–94.2%] and 84.1% (95% CI: 74.9–90.1%) in the GEP and no GEP groups respectively (P = 0.49). Median time to death from metastasis was 10.1 months in the GEP group and 8.5 months in the no GEP group (P = 0.40). There were no significant differences in time to metastasis diagnosis and survival outcomes in patients with and without GEP. To realize the full benefit of GEP, more sensitive techniques for detection of metastasis and adjuvant therapies are required.

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Metastatic Risk Factors Associated with Class 1A Uveal Melanoma Patients

Cited by 8 publications

References 24 publications

Comparative Metastatic Rates in GEP Class 1A versus 1B Posterior Uveal Melanoma: Results Contrary to Expectations

Comparative Metastatic Rates in GEP Class 1A versus 1B Posterior Uveal Melanoma: Results Contrary to Expectations

Response to Cook and Alsina’s Letter to Editor (Reply to Augsburger et al.)

Impact of gene expression profiling on diagnosis and survival after metastasis in patients with uveal melanoma

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