Melanoma Research: Real-world performance and utility of a noninvasive gene expression assay to evaluate melanoma risk in pigmented lesions

About 3 million surgical pigmented skin lesion biopsies are performed each year in the USA alone to diagnose fewer than 200 000 new cases of invasive melanoma and melanoma in situ using the current standard of care that includes visual assessment and histopathology. A recently described noninvasive adhesive patch-based gene expression rule-out test [pigmented lesion assay (PLA)] may be helpful in identifying high-risk pigmented skin lesions to aid with surgical biopsy decisions.

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JAMA: Economic Analysis of a Noninvasive Molecular Pathologic Assay for Pigmented Skin Lesions

Question: What are the economic implications of using a noninvasive gene expression test (the pigmented lesion assay) to rule out melanoma and the need for surgical biopsy of atypical pigmented lesions suggestive of melanoma? Findings: In this cost-savings analysis of the pigmented lesion assay using model inputs for patients with pigmented lesions suggestive of melanoma, a $447 (47%) cost reduction per assessed pigmented lesion vs the current histopathologic standard of care was achievable if the assay was priced at $500.

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JAMA Letter

Not missing melanomas in daily practice keeps dermatologists up at night and is a challenge even for dermatologists who see pigmented lesion cases regularly.

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