TY - JOUR
T1 - Molecular Prognostic Testing and Individualized Patient Care in Uveal Melanoma
AU - Harbour, J. William
N1 - Funding Information:
This study was supported by the National Cancer Institute (R01 CA125970), Bethesda, Maryland; Barnes-Jewish Hospital Foundation, St. Louis, Missouri; Tumori Foundation, San Francisco, California; Kling Family Foundation, St. Louis, Missouri; Horncrest Foundation, Ossining, New York; Research to Prevent Blindness Inc, New York, New York; and New England Retina Research & Education Foundation, Hamden, Connecticut. Washington University has filed a provisional patent on the UM-GEP assay that is mentioned in the article. The author has received no remuneration for this patent. The author was involved in design and conduct of study; data collection; management, analysis, and interpretation of data; and preparation, review, and approval of the manuscript. Institutional Review Board approval was not needed for this study.
PY - 2009/12
Y1 - 2009/12
N2 - Purpose: To critically assess the status of molecular prognostic testing and its use for individualized patient care in uveal melanoma. Design: Perspective, literature review, evidence assessment, and commentary. Methods: Evaluation of selected articles from the literature and the authors' clinical and laboratory studies. Results: The most accurate molecular tests for predicting metastatic death in patients with uveal melanoma currently involve automated techniques for assessing deoxyribonucleic acid (DNA) copy number alterations and gene expression profiling. Most tests reported in the literature to date do not provide adequate scientific and statistical validation to be used outside of an ethically supervised investigational environment. Conclusions: Many cytogenetic and molecular prognostic tests for uveal melanoma have been reported, yet few have reached the standards required for routine clinical testing. Clinicians must understand the statistical and scientific limitations of the tests they are using, and appropriate ethical oversight is essential until such time that validated testing instruments are available that are performed in a standardized clinical testing environment. Well-controlled prospective studies are necessary to identify the most accurate, widely accessible, and affordable tests for routine clinical use.
AB - Purpose: To critically assess the status of molecular prognostic testing and its use for individualized patient care in uveal melanoma. Design: Perspective, literature review, evidence assessment, and commentary. Methods: Evaluation of selected articles from the literature and the authors' clinical and laboratory studies. Results: The most accurate molecular tests for predicting metastatic death in patients with uveal melanoma currently involve automated techniques for assessing deoxyribonucleic acid (DNA) copy number alterations and gene expression profiling. Most tests reported in the literature to date do not provide adequate scientific and statistical validation to be used outside of an ethically supervised investigational environment. Conclusions: Many cytogenetic and molecular prognostic tests for uveal melanoma have been reported, yet few have reached the standards required for routine clinical testing. Clinicians must understand the statistical and scientific limitations of the tests they are using, and appropriate ethical oversight is essential until such time that validated testing instruments are available that are performed in a standardized clinical testing environment. Well-controlled prospective studies are necessary to identify the most accurate, widely accessible, and affordable tests for routine clinical use.
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U2 - 10.1016/j.ajo.2009.07.004
DO - 10.1016/j.ajo.2009.07.004
M3 - Article
C2 - 19800609
AN - SCOPUS:70449685754
SN - 0002-9394
VL - 148
SP - 823-829.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 6
ER -