Case Study 1: Gene Expression Profililing in Stage IB Melanoma

Vernon Sondak, MD, and Tina J. Hieken, MD, examine the role of gene expression profile testing in sentinel lymph node biopsy decision-making through a clinical case involving a patient with Stage IB melanoma. The discussion considers estimated sentinel lymph node positivity risk, the use and limitations of clinical nomograms, patient age and comorbidities, and findings from the prospective MERLIN_001 study. Drs. Sondak and Hieken also discuss how gene expression profiling may provide additional information for selected patients with T1b or T2a melanoma and how that information can be incorporated into shared decision-making between the healthcare professional and patient.