Key takeaways:

• Genomics increased accuracy in distinguishing between lesion types.
• Pediatric melanoma accounts for less than 1% of all melanomas.

NEW ORLEANS — Integrating genomic testing along with clinical and pathology information will lead to increased accuracy and detection of melanoma in pediatric patients, according to a speaker here.

“This concept of pediatric melanoma has evolved over the year, and now I think we finally have the tools to put everything together,” Alberto S. Pappo, MD, of St. Jude Children’s Research Hospital in Memphis, Tennessee, told Healio. “An integrated analysis of lesions will ultimately give us a better idea of how a lesion is going to behave in a child and will guide us through therapy.”

Pediatric melanoma accounts for less than 1% of all melanomas, according to Pappo. Due to its rarity among children, atypical presentation and ambiguous histology, this population often suffers disease progression from delayed diagnoses.

Alberto S. Pappo

During his presentation at The Society for Pediatric Dermatology Meeting, which preceded the American Academy of Dermatology Annual Meeting, Pappo explained that incorporating genomics assists in earlier diagnosis and guiding treatment in pediatric patients.

According to Pappo’s presentation, the accuracy of distinguishing between Spitz and non-Spitz lesions before utilizing genomics was 0.267 compared with 0.835 after genomics. The same applied in conventional melanoma vs. unconventional melanoma, with pre-genomic outcomes being less accurate than post-genomic outcomes (0.323 vs. 0.689, respectively).

Utilizing genomics also limits steps that may be unnecessary in children, such as surgeries, lymph node dissections or adjuvant therapies.

“I strongly encourage clinicians to ensure genomic tests are done in the tumors because ultimately that can affect the care of their patients,” Pappo concluded.

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