Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov;14(7):586-596.
doi: 10.6004/jadpro.2023.14.7.3. Epub 2023 Nov 1.

Clinical Utility of the 31-Gene Expression Profile Test on the Management of Cutaneous Melanoma by Nurse Practitioners and Physician Assistants

Renata Block  1 , Deborah Patterson  1 , Jennifer J Siegel  2 , Brian Martin  2 , Ann P Quick  2 , Jillian Hunt  3
Affiliations

Clinical Utility of the 31-Gene Expression Profile Test on the Management of Cutaneous Melanoma by Nurse Practitioners and Physician Assistants

Renata Block et al. J Adv Pract Oncol. 2023 Nov.

Abstract

Objective: The 31-gene expression profile (31-GEP) can predict the risk of recurrence and metastasis in cutaneous melanoma (CM). We assessed the viewpoints and use of 31-GEP testing by physician assistants (PAs) and nurse practitioners (NPs) for patients with CM.

Methods: NPs and PAs (n = 369) completed an 18-question online survey about their viewpoints and use of the 31-GEP risk-stratification test.

Results: Most practitioners (n = 334, 90.5%) felt prognostic testing improved patient care and would recommend the 31-GEP to a colleague (n = 333, 90.2%) or a friend or family member (n = 289, 78.3%) who was diagnosed with CM. The 31-GEP test was used by 176 respondents in the preceding 12 months (53%). Among users of the 31-GEP test, 78% stated that the results would impact follow-up schedule and referral, 66% overall treatment decisions, 62% sentinel lymph node biopsy recommendations, and 50% surveillance imaging. In thin tumors (≤ 1 mm), 82% of 31-GEP users and 44% of nonusers stated that the 31-GEP results would impact their treatment plan decisions.

Conclusion: The 31-GEP test significantly impacts treatment plans in CM, particularly for thin and stage I melanomas. Importantly, even nonusers stated that 31-GEP test results would impact treatment plans as well as recommendations to a friend or family member.

PubMed Disclaimer

Conflict of interest statement

This study was funded by Castle Biosciences, Inc. Ms. Block has no conflicts of interest and nothing to declare. Ms. Patterson, Dr. Siegel, Dr. Martin, and Dr. Quick are employees, and stock and options holders at Castle Biosciences, Inc. Ms. Hunt is on the speakers bureau at Castle Biosciences, Inc.

Figures

Figure 1
Figure 1
Factors that influence the decision to order the 31-GEP test. Providers were asked (A) what factors they consider when deciding whether to order 31-GEP testing, and (B) what tumor-specific factors would make them more likely to order 31-GEP testing. Participants could select all choices that applied, and the percentage of users (blue) or nonusers (orange) that selected a given choice are shown in the graphs. The table indicates the number of users or nonusers who selected a given choice.
Figure 2
Figure 2
Responses regarding if a Class 2B result would change their patient management. Respondents were asked if receiving a Class 2B 31-GEP result would change their management plan for a patient with a thin (T1) (A) or stage I (B) tumor. The percentage of users (blue) or nonusers (orange) that selected each choice are shown in the graphs. The table indicates the number of users or nonusers who selected a given choice.
Figure 3
Figure 3
Responses regarding the benefits of a Class 1A result for providers. Respondents were asked what they felt was the value in receiving a Class 1A (low risk) result for a patient with a T1a tumor. Respondents could select as many choices as applied. The percent of users (blue) or nonusers (orange) that selected each choice are shown in the graphs. The table indicates the number of users or nonusers who selected a given choice.
Figure 4
Figure 4
Likeliness to recommend 31-GEP testing. Respondents were asked (A) how likely they would be to recommend use of 31-GEP testing to a colleague and (B) if they would recommend testing to a friend or close relative who was diagnosed with melanoma.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Berger, A. C., Davidson, R. S., Poitras, J. K., Chabra, I., Hope, R., Brackeen, A.,… Miller, A. R. (2016). Clinical impact of a 31-gene expression profile test for cutaneous melanoma in 156 prospectively and consecutively tested patients. Current Medical Research and Opinion, 32(9), 1599–1604. 10.1080/03007995.2016.1192997 - DOI - PubMed
    1. Bollard, S. M., Casalou, C., & Potter, S. M. (2021). Gene expression profiling in melanoma: A view from the clinic. Cancer Treatment and Research Communications, 29, 100447. 10.1016/j.ctarc.2021.100447 - DOI - PubMed
    1. Bruinooge, S. S., Pickard, T. A., Vogel, W., Hanley, A., Schenkel, C., Garrett-Mayer, E.,… Williams, S. F. (2018). Understanding the role of advanced practice providers in oncology in the United States. Journal of Oncology Practice, 14(9), e518–e532. 10.1200/JOP.18.00181 - DOI - PubMed
    1. Chandler, Y., Schechter, C. B., Jayasekera, J., Near, A., O’Neill, S. C., Isaacs, C.,… Mandelblatt, J. S. (2018). Cost effectiveness of gene expression profile testing in community practice. Journal of Clinical Oncology, 36(6), 554–562. 10.1200/JCO.2017.74.5034 - DOI - PMC - PubMed
    1. Cohen, P. R., & Kurzrock, R. (2022). Dermatologic disease-directed targeted therapy (D3T2): The application of biomarker-based precision medicine for the personalized treatment of skin conditions-precision dermatology. Dermatology and Therapy, 12, 2249–2271. - PMC - PubMed

LinkOut - more resources