Bridging the Gap: Integrating Gene Expression Profiling into Clinical Practice
Clinicians who treat patients with cutaneous squamous cell carcinoma (CSCC) face a unique set of management challenges. While the aim is to identify biologically aggressive tumors at earlier stages of progression and tumors that may be more advanced but pose lower than predicted risk, prognostication is not always accurate. Furthermore, even after careful clinical and histopathologic risk stratification, there remains significant variability in managing patients with high-risk CSCC. To address this challenge, experts are evaluating tools designed to improve risk stratification of these patients as discussed by the authors of this article.
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Clinical Considerations for Integrating Gene Expression Profiling into Cutaneous Squamous Cell Carcinoma Management
Gene expression profile (GEP) testing is now commercially available for metastatic risk prediction in patients with cutaneous squamous cell carcinoma (CSCC) and one or more high-risk factors. The purpose of this article is to provide an early framework for healthcare providers looking to integrate patient-specific tumor biology into their clinical practice using GEP testing. To develop a framework for clinical use, an expert panel was convened to identify CSCC management decision points where GEP testing may be immediately incorporated into practice until the definitive results of prospective trials become available. Based on their discussion, the expert panel focused on the areas of nodal evaluation, adjuvant radiation therapy, and follow-up and surveillance. The panel emphasized that GEP prognostic test results should not currently be used as a surrogate for standard of care treatment but as an additional data point when determining individualized management for patients with high-risk CSCC. Whenever possible, decisions on management plans for these patients should be developed with multidisciplinary input.
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