How have you incorporated gene expression profiling tests for melanoma or SCC into your practice and has it changed your approach to treatment and/or monitoring?

We routinely utilize GEP testing for our melanoma and high-risk SCC patients. For melanoma, it helps refine the care we offer. For T1a high-risk, T1b, and T2a melanomas, it helps rule in or rule out a Sentinel Lymph Node Biopsy (SLNB), or even guide imaging protocols. For node-negative patients, a h...

This is a controversial topic for sure, but most emerging technologies in medicine are.

I do use gene-expression profiling in the treatment of cutaneous SCC and invasive melanoma. My theoretical framework for using GEP testing is that it is a forward looking test, while clinical staging is backward...

Despite the lack of guideline endorsement, GEP testing is being used by a substantial number of clinicians in practice (Fastner et al., PMID 38098216). The SSO consensus statement raised concerns about industry sponsorship and authorship of much of the supporting literature, short follow-up duration...

I had a few patients call my office when they saw the cost of these tests on their EOBs. While they themselves didn't have to pay, they weren't happy with the cost of the tests and wondered why I did them, one actually wondering if I was getting a "kickback".

Not once did I have to change my treatme...

I have regularly used next-generation sequencing (NGS) to profile advanced melanoma patients' tumors to determine potential targetable mutations such as BRAF, NRAS, c-KIT, NTRK, etc. There are available oral targeted therapies for those mutations. NGS is particularly useful in patients who cannot to...