Genetic Profiling Improves Prognosis of Uveal Melanoma

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(ChemotherapyAdvisor) – Gene expression profiling (GEP) and chromosomal analysis show prognostic value in patients with uveal melanoma, according to research groups from several institutions within the continental United States and Canada. This conclusion is based on a paper titled “Collaborative Ocular Oncology Group Report Number 1: Prospective Validation of a Multi-Gene Prognostic Assay in Uveal Melanoma,” which will be published in an upcoming issue of Ophthamology, but is now available online.

In this prospective, multicenter study, the investigators evaluated a 15 gene expression profiling (GEP) assay that classifies primary posterior uveal melanomas according to their risk of metastasis: class 1 (low metastatic risk) and class 2 (high metastatic risk). Tumors from a total of 459 patients were classified by GEP; the first 260 samples were also analyzed for chromosome 3 status using a single nucleotide polymorphism assay. As a primary outcome measure, primary tumors were managed and patients were monitored for metastasis.

Four hundred forty-six (446) cases were successfully classified by GEP: 276 cases (61.9%) were class 1 and 170 cases (38.1%) were class 2. Median follow-up was 17.4 months (mean, 18.0 months). Metastasis was detected in 3 class 1 cases (1.1%) and 44 class 2 cases (25.9%) (log-rank test, P<10−14). Although there was an association between GEP class 2 and monosomy 3 (Fisher exact test, P<0.0001), 54 of 260 tumors (20.8%) were discordant for GEP and chromosome 3 status, among which GEP demonstrated superior prognostic accuracy (log-rank test, P=0.0001).

The investigators concluded that the GEP assay was the most accurate prognostic marker among all of the factors analyzed and chromosome 3 status did not provide prognostic information that was independent of GEP.


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