Faculty Bibliography
Searched for:
in-biosketch:true
person:rigeld01
Total Results:
270
Validation of a 40-Gene Expression Profile Test to Predict Metastatic Risk in Localized High-Risk Cutaneous Squamous Cell Carcinoma
BACKGROUND:Current staging systems for cutaneous squamous cell carcinoma (cSCC) have limited positive predictive value (PPV) for identifying patients who will experience metastasis. OBJECTIVE:To develop and validate a gene expression profile (GEP) test for predicting risk for metastasis in localized, high-risk cSCC with the goal of improving risk-directed patient management. METHODS:Archival formalin-fixed paraffin-embedded primary cSCC tissue and clinicopathologic data (n=586) were collected from 23 independent centers in a prospectively designed study. A GEP signature was developed using a discovery cohort (n=202) and validated in a separate, non-overlaping, independent cohort (n=324). RESULTS:A prognostic, 40-gene expression profile (40-GEP) test was developed and validated, stratifying high-risk cSCC patients into classes based on metastasis risk: Class 1 (low-risk), Class 2A (high-risk), and Class 2B (highest-risk). For the validation cohort, 3-year metastasis-free survival (MFS) rates were 91.4%, 80.6%, and 44.0%, respectively. A PPV of 60% was achieved for the highest-risk group (Class 2B), an improvement over staging systems; while negative predictive value, sensitivity, and specificity were comparable to staging systems. LIMITATIONS/CONCLUSIONS:Potential understaging of cases could affect metastasis rate accuracy. CONCLUSION/CONCLUSIONS:The 40-GEP test is an independent predictor of metastatic risk that can complement current staging systems for patients with high-risk cSCC.
PMID: 32344066
ISSN: 1097-6787
CID: 4412182
A demonstration of the excellent tolerability and safety of a lanolin alcoholecontaining wound healing ointment [Meeting Abstract]
ISI:000598634300646
ISSN: 0190-9622
CID: 4730212
The Immediate Impact of COVID-19 on US Dermatology Practices
PMCID:7228885
PMID: 32422226
ISSN: 1097-6787
CID: 4443842
Impact of a prognostic 40-gene expression profiling test on clinical management decisions for high-risk cutaneous squamous cell carcinoma
PMID: 32372702
ISSN: 1473-4877
CID: 4430212
Improvement of risk assessment in cutaneous melanoma (CM) by a prognostic 31-gene expression profile (31-GEP) test over AJCCbased staging alone [Meeting Abstract]
Background/Objective: Accurate assessment of recurrence and metastatic risk is critical for cutaneous melanoma (CM) patient management decisions. Patients initially diagnosed with Stage I to II disease account for a large proportion of those who develop metastases and die from CM, suggesting a need for additional prognostic tools. The 31-Gene Expression Profile (GEP) test has been shown to stratify risk of developing metastasis within five years into low risk (Class 1; 1A lowest risk) and high risk (Class 2; 2B highest risk) and improves prognostic assessment for patients with melanoma. The test has been demonstrated to guide follow-up intensity, sentinel lymph node biopsy decisions, surveillance use, and possible adjuvant therapy. The current study evaluated performance of the 31-GEP test and its ability to improve accuracy of risk estimates over American Joint Committee on Cancer (AJCC) staging alone.
Method(s): Archival primary CM tumor samples from 18 centers in the United States (N=690, Stage I-III) along with clinicopathological and outcomes data were collected under an Institutional Review Board (IRB)-approved protocol. Stage I to II cases were restaged according to AJCC 8th edition. Class 1A and 2B-predicted melanoma-specific survival (MSS) outcomes for each stage were compared to rates associated with AJCC stage only. The Kaplan-Meier method and log-rank tests were used to assess five-year recurrence-free (RFS), distant metastasis-free survival (DMFS), and MSS rates.
Result(s): The 690-case cohort demonstrated stagespecific MSS rates matching those from the AJCC 8th edition cohort ('+/-1.2%). Class 2B cases had significantly worse RFS, DMFS, and MSS compared to Class 1A cases (p<0.0001). Across all stages, a 31-GEP result identified cases with improved (Class 1A) and worsened (Class 2B) prognoses compared to the risks predicted by clinicopathologic stage alone. Stage I patients have a five-year AJCC MSS rate of 98 percent, with the 690-case cohort rate at 98.5 percent. While Stage I Class 1A cases had a MSS rate of 99.6 percent (Stage IA equivalent), a Class 2B result was associated with a MSS rate between AJCC Stage IIA-IIB risk (MSS=89.5%). Stage II patients have a five-year AJCC MSS rate of 90 percent, with the 690-cohort rate at 90.7 percent. Among these cases, the MSS rate of Class 1A cases was greater than 99 percent (Stage IA equivalent), while for Class 2B cases, it was 84.7 percent (MSS between Stage IIB-IIC). Stage III patients have five-year MSS rates of 77 percent and 75.8 percent in the AJCC and 690-cohorts, respectively. Stage III Class 1A cases had an MSS rate of 94.8 percent (similar to Stage IIA), and Class 2B cases demonstrated a rate of 61.2 percent (worse than Stage IIIC).
Conclusion(s): This study demonstrates that 31-GEP testing adds prognostic value by further stratifying risk for melanoma-related mortality to improve risk estimates beyond AJCC staging alone
Method(s): Archival primary CM tumor samples from 18 centers in the United States (N=690, Stage I-III) along with clinicopathological and outcomes data were collected under an Institutional Review Board (IRB)-approved protocol. Stage I to II cases were restaged according to AJCC 8th edition. Class 1A and 2B-predicted melanoma-specific survival (MSS) outcomes for each stage were compared to rates associated with AJCC stage only. The Kaplan-Meier method and log-rank tests were used to assess five-year recurrence-free (RFS), distant metastasis-free survival (DMFS), and MSS rates.
Result(s): The 690-case cohort demonstrated stagespecific MSS rates matching those from the AJCC 8th edition cohort ('+/-1.2%). Class 2B cases had significantly worse RFS, DMFS, and MSS compared to Class 1A cases (p<0.0001). Across all stages, a 31-GEP result identified cases with improved (Class 1A) and worsened (Class 2B) prognoses compared to the risks predicted by clinicopathologic stage alone. Stage I patients have a five-year AJCC MSS rate of 98 percent, with the 690-case cohort rate at 98.5 percent. While Stage I Class 1A cases had a MSS rate of 99.6 percent (Stage IA equivalent), a Class 2B result was associated with a MSS rate between AJCC Stage IIA-IIB risk (MSS=89.5%). Stage II patients have a five-year AJCC MSS rate of 90 percent, with the 690-cohort rate at 90.7 percent. Among these cases, the MSS rate of Class 1A cases was greater than 99 percent (Stage IA equivalent), while for Class 2B cases, it was 84.7 percent (MSS between Stage IIB-IIC). Stage III patients have five-year MSS rates of 77 percent and 75.8 percent in the AJCC and 690-cohorts, respectively. Stage III Class 1A cases had an MSS rate of 94.8 percent (similar to Stage IIA), and Class 2B cases demonstrated a rate of 61.2 percent (worse than Stage IIIC).
Conclusion(s): This study demonstrates that 31-GEP testing adds prognostic value by further stratifying risk for melanoma-related mortality to improve risk estimates beyond AJCC staging alone
EMBASE:629676608
ISSN: 1941-2789
CID: 4168482
The Low Prevalence of Allergic Contact Dermatitis Using a Petrolatum Ointment Containing Lanolin Alcohol
ISI:000488330900004
ISSN: 1545-9616
CID: 4135862
Impact of Gene Expression Profile Testing on the Management of Squamous Cell Carcinoma by Dermatologists
Background: The incidence of cutaneous squamous cell carcinoma (cSCC) is increasing likely due to improved detection and a growing elderly population. Although the prognosis of cSCC is excellent with complete surgical excision, many patients who go on to develop metastasis are initially classified as low-risk. The most commonly used staging systems, American Joint Committee on Cancer (AJCC) and Brigham Women's Hospital (BWH), have low sensitivity and low positive predictive value for predicting metastasis. A gene expression profile test (cSCC-GEP) is in development to identify patients with cSCC at high risk for metastasis and death.
PMID: 31584775
ISSN: 1545-9616
CID: 4118782
Analysis of best selling sunscreens: Consumer preferences, product characteristics, and active ingredients [Meeting Abstract]
ISI:000482195000068
ISSN: 0190-9622
CID: 4086012
Improved risk assessment through incorporation of a prognostic 31-gene expression profile test for AJCC stage IB-IIA cutaneous melanoma [Meeting Abstract]
ISI:000482195002094
ISSN: 0190-9622
CID: 4086122
Corrigendum: Impact on clinical practice of a non-invasive gene expression melanoma rule-out test: 12-month followup of negative test results and utility data from a large US registry study
The revised version of the article corrected Figure 2. This change appears in the revised online PDF copy of this article.
PMID: 31329399
ISSN: 1087-2108
CID: 3986782
