Limitations of GEP in cSCC

In “Limitations of GEP in cSCC,” our panel explores the current limitations, unanswered questions, and future research needs surrounding gene expression profiling (GEP) in cutaneous squamous cell carcinoma (cSCC). The expert faculty discuss how GEP has emerged as a valuable tool for predicting metastatic risk and recurrence, while also highlighting important areas where additional evidence and clinical guidance are still needed.

The panel reviews current challenges related to integrating GEP results into decisions regarding adjuvant radiation therapy, imaging, and sentinel lymph node biopsy. The expert faculty discuss how variability in imaging practices, including differences in access to nodal ultrasound and other surveillance tools, may affect implementation of molecularly informed management strategies across practice settings.

Additionally, the discussion examines broader limitations associated with GEP evidence generation, including the absence of randomized controlled trials and the ethical complexities involved in designing studies that withhold potentially beneficial interventions from high-risk patients identified through molecular profiling. The panelists also discuss how evolving evidence continues to support the prognostic value of GEP despite these limitations and how clinicians balance existing data with real-world decision-making in multidisciplinary cancer care. Throughout the discussion, the expert faculty emphasize the importance of continuing research efforts to refine the clinical applications of GEP and improve personalized management strategies for patients with cSCC.

Our next episode, “Access Challenges with GEP in cSCC,” explores how gene expression profiling results are interpreted in clinical practice and how molecular risk information may support treatment planning, surveillance strategies, and multidisciplinary management decisions in patients with cSCC.