The DecisionDx-Melanoma prognostic test improves risk assessment and allows physicians to optimize treatment decisions, follow-up frequency and the need for imaging, according to a study presented at the American Society for Dermatologic Surgery annual meeting.
Using tissue from the primary melanoma, the gene expression profile test predicts an individual’s risk for cutaneous melanoma metastasis or recurrence, in addition to sentinel lymph node positivity, according to a press release from Castle Biosciences.
In the study, 1,124 patients with melanoma were included from nine dermatology centers participating in the Cutaneous Oncology Research Consortium (CORC).
Patients with at least 1 year of follow-up or a recurrence who had complete clinicopathologic information and a DecisionDx-Melanoma result available were included in the nomogram development (n = 685), according to the release.
Most patients (84%) had a tumor 1 mm deep or less and ulceration was present in 7% of patients.
The DecisionDx-Melanoma prognostic test for cutaneous melanoma predicts 5-year risk for recurrence and metastasis as low risk or high risk, according to the release.
In the study, those with class 1A DecisionDx-Melanoma test results had significantly better recurrence-free survival at 1.5 years (98.9%) compared with those with class 2B results (70.3%).
Significant predictors for recurrence-free survival were Breslow thickness (HR = 1.25, P = .0002) and DecisionDx-Melanoma results (HR = 9.02, P < .0001).
The company developed an optimized nomogram including American Joint Committee on Cancer T category and DecisionDx-Melanoma test results. To validate the nomogram, it was tested in a retrospective cohort of 901 patients who had a median follow-up of 5.8 years. The validated nomogram improved recurrence risk prediction beyond clinicopathologic factors alone, according to the release.
Thorpe R, et al. Development and validation of a clinically useful nomogram incorporating molecular clinicopathologic factors to predict risk of recurrence in patients with cutaneous melanoma. Presented at: American Society for Dermatologic Surgery annual meeting; Oct. 24-27, 2019; Chicago.