Impact of a prognostic 40-gene expression profiling test on clinical management decisions for high-risk cutaneous squamous cell carcinoma

Dermatologic Disease-Directed Targeted Therapy (D3T2): The Application of Biomarker-Based Precision Medicine for the Personalized Treatment of Skin Conditions—Precision Dermatology

“…For example, some of the cutaneous SCC patients who were initially classified as low risk developed metastatic disease. In addition, other patients with cutaneous SCC who are classified as high-risk do not develop metastases [82][83][84][85][86][87][88][89][90][91][92].…”

“…A 40-GEP test has been developed to improve identification of individuals with primary cutaneous SCC who have a high risk of subsequently developing metastatic disease and to guide the decisions made by physicians regarding the possible performance of sentinel lymph node biopsy, potential management (such as radiation, chemotherapy, or immunotherapy), and follow-up intervals (ranging from every 3 to 6 to 12 months). The test can be used for a cutaneous SCC patient with one or more risk factors (Table 2) [82,[85][86][87][88][89][90][91][92]. Indeed, when it is used in combination with traditional risk factors, the result provides additional risk prediction of metastasis and death for the patient [82][83][84][85][86][87][88][89][90][91][92].…”

“…The test can be used for a cutaneous SCC patient with one or more risk factors (Table 2) [82,[85][86][87][88][89][90][91][92]. Indeed, when it is used in combination with traditional risk factors, the result provides additional risk prediction of metastasis and death for the patient [82][83][84][85][86][87][88][89][90][91][92].…”

“…RNA is extracted after macrodissection of the cutaneous SCC tumor tissue (including tumor stroma) from the formalin-fixed, paraffin-embedded tissue biopsy specimen. Subsequently, qRT-PCR is used to generate complementary DNA so that the expression of the 40 genes can be quantified and the tumor's risk for metastasis can be classified [82][83][84][85][86][87][88][89][90][91][92].…”

“…The metastasis rate for primary cutaneous SCC patients with one high-risk factor was 4%, 10.8%, and 60.0% for individuals classified as class 1, class 2A, and class 2B, respectively. Also, the metastasis rate for primary cutaneous SCC patients with two or more highrisk factors was 9%, 25.0%, and 50.0% for individuals classified as class 1, class 2A, and class 2B, respectively [82][83][84][85][86][87][88][89][90][91][92].…”