The Evolving Clinical Utility of Gene Expression Profiling in Cutaneous Melanoma

Cutaneous melanoma risk assessment relies on clinicopathologic staging, which incompletely captures individual risk of nodal involvement, recurrence, and melanoma-specific mortality. Gene expression profiling (GEP) assays have been proposed to refine prognostication by measuring multigene transcriptional signatures from primary tumors. Here, we review the development, validation evidence, and limitations of the 2 most studied GEP tests for primary melanoma, and we evaluate their potential clinical utility amid rapidly evolving treatment paradigms. We highlight key knowledge gaps that should be addressed before advocating for broader GEP assay implementation.