Possible Melanoma? Noninvasive Gene Expression Adds Diagnostic Info

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“even pigmented lesion experts surgically biopsy about half as often and miss fewer melanoma when adding the pigmented lesion assay to their decision process,”

Diagnosing melanoma is difficult. Even experts can get it wrong. That’s not an insult. I’m saying that it is over-treatment to biopsy every mole and freckle just to be sure and may be under-treatment to biopsy only those moles that you think are melanoma. And an expert maybe missing a mole that is cancer.

Pairing real life with studies below is a great way to illustrate abstract concepts. Sammy (not his real name) is an old friend of mine who is a melanoma survivor. His cancer was almost overlooked.

Sammy commented:

Melanoma showing changes in color

“I had a small mole on my face below and to the right of my right eye. It had changed color and Jane suggested that I have it looked at. I went to my GP and she indicated it looked fine and were it not for a full waiting room she would have cut it out right then. I asked for a referral to a dermatologist and she rolled her eyes, said yes and suggested it would be a very long time…

When we arrived back (from vacation) I learned that the little spot on my face was melanoma and that I needed to see a surgeon right away.

From here things just seemed to get worse- at first, “it’s only little, not very deep”  to “it’s deeper than we thought’ . when I asked what that meant, the surgeon replied- ‘ it means you will need chemo and it means you will probably feel like shit for the next year, ask your oncologist”.

I am a cancer survivor and cancer coach. Twenty plus years of living with an “incurable” cancer has taught me that cancer patients live better, longer lives when they help conventional oncology.

Have you been diagnosed with melanoma? What stage? Scroll down the page, post a question or comment and I will reply to you ASAP.

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Pigmented lesion assay improves biopsy specificity in diagnosing melanoma

“The use of a noninvasive pigmented lesion assay significantly improved biopsy specifity, which may allow dermatologists to miss fewer melanomas while reducing the number of benign lesions biopsied, according to study results recently published in JAMA Dermatology

“The utility study demonstrates that even pigmented lesion experts surgically biopsy about half as often and miss fewer melanomas when adding the pigmented lesion assay to their decision process,”

The dermatologists reviewed the images without and with noninvasive pigmented lesion assay (PLA, DermTech) gene expression information and were then asked if the lesions should be biopsied

A report for each lesion, including the results of an assay for expression of LINC00518/PRAME and a PLA score with data on the predictive values of the information were provided to the dermatologists

There were 581 fewer decisions to biopsy benign lesions of a total of 2,340 decisions when PLA was introduced…”

Analytical Characteristics of a Noninvasive Gene Expression Assay for Pigmented Skin Lesions.

“All target qPCRs demonstrated a good specificity (100%) and sensitivity (with a limit of detection of 1-2 copies), which allows reliable detection of gene expression changes of LINC and PRAME between melanomas and non melanomas...

This two-gene PLA demonstrates a high repeatability and reproducibility (coefficient of variation <3%) and all required analytical performance characteristics for the commercial processing of clinical samples…”





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