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July 29, 2020

Consensus, Controversy, and Conversations About Gene Expression Profiling in Melanoma

Author Affiliations
  • 1Department of Dermatology, Stanford University School of Medicine, Stanford, California
  • 2Department of Medicine, School of Medicine, Baylor College of Medicine, Houston, Texas
  • 3Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston
JAMA Dermatol. Published online July 29, 2020. doi:10.1001/jamadermatol.2020.1730

Personalized medicine, which is clinical management tailored to the individual patient, is gaining increased attention in every specialty. Gene expression profiling (GEP) measures the levels of multiple genes in an individual’s tumor and predicts a clinical outcome (eg, melanoma recurrence) based on advanced machine learning and artificial intelligence algorithms. Although not yet endorsed by the American Academy of Dermatology or the National Comprehensive Cancer Network, the use of GEP is increasing, with approximately 12 000 DecisionDx-Melanoma tests processed per year.1 As GEP tests penetrate the dermatology market, it is increasingly important for dermatologists to have a clear understanding of GEP science and its utility. In this issue, Marchetti et al2 report the performance of GEP tests across 7 external validation studies in a systematic review and meta-analysis, whereas Grossman et al3 discuss the issues that need to be addressed before GEP tests can be integrated into clinical decision-making.3 Neither article provides strong support for GEP use in its current form.

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