VIENNA, Austria — New findings from the largest prospective, multi-center study of its kind suggest that molecular diagnostic testing could fundamentally reshape how physicians approach the treatment of cutaneous melanoma. Data presented today at the European Academy of Dermatology and Venereology (EADV) Congress reveal that the DecisionDx-Melanoma gene expression profile (GEP) test can accurately identify patients who may safely avoid invasive procedures, as well as those who require more aggressive follow-up.
The study, which tracked 2,799 patients across 29 U.S. centers, evaluated the test’s ability to predict the risk of sentinel lymph node (SLN) positivity and overall recurrence. The results offer a compelling case for integrating tumor biology into standard clinical staging.
Among the key findings, patients who received a “low-risk” i31-SLNB score—indicating less than a 5% predicted risk of nodal involvement—showed an actual SLN positivity rate of only 4.4%. For patients classified as low risk who elected to forgo the sentinel lymph node biopsy (SLNB) procedure entirely, the results were highly favorable, with a five-year recurrence-free survival (RFS) rate of 99.6%.
“Staging is an essential starting point, but understanding a patient’s tumor biology can help us make more informed recommendations about sentinel lymph node biopsy and follow-up care,” said Dr. Joseph Gadzia, a study author and dermatologist at Kansas Medical Center. “Seeing excellent outcomes among patients with low-risk results who did not undergo the procedure should give physicians greater confidence in using these test results to guide care.”
The data also highlight the test’s prognostic value for early-stage patients whose risk may be underestimated by traditional AJCC staging. For patients with stage I or IIA melanoma who received high-risk “Class 2B” results, the five-year RFS was significantly lower, mirroring the recurrence risk typically seen in patients with more advanced stage IIB disease. Researchers argue that these findings support a more personalized approach to surveillance, suggesting that these high-risk, early-stage patients may benefit from more frequent monitoring and imaging that would not be standard practice based on clinical stage alone.
A separate ePoster presented at the EADV Congress addressed the challenge of “transected” tumors—biopsies where the sample fails to capture the full thickness of the tumor, creating uncertainty in staging. The study of 687 patients showed that DecisionDx-Melanoma effectively stratified these patients into high and low risk of recurrence, providing a clear pathway for management when traditional pathology remains incomplete.
As precision medicine continues to advance in dermatology, the latest data suggest that Castle Biosciences’ molecular testing provides a bridge between initial diagnosis and personalized treatment planning, allowing clinicians to tailor care to the specific biological signature of each patient’s cancer.
Disclaimer: This content is auto-generated for informational purposes only.
Source: Read Original News
