Castle Bioscience’s DecisionDx-SCC Test Boosts Mohs Surgeons' Confidence

DecisionDx-SCC is Castle’s prognostic 40-GEP test designed to use a patient’s tumor biology to predict individual risk of metastasis for patients diagnosed with cutaneous squamous cell carcinoma who have one or more high-risk factors.

Castle Bioscience’s DecisionDx-SCC test results can assist Mohs surgeons in making risk-aligned management plans and increase confidence in their treatment decisions, according to data presented at the 2022 American Society for Dermatologic Surgery (ASDS) Annual Meeting.

DecisionDx-SCC is Castle’s prognostic 40-GEP test designed to use a patient’s tumor biology to predict individual risk of metastasis for patients diagnosed with cutaneous squamous cell carcinoma (SCC) who have one or more high-risk factors. The test stratifies patients into one of three classes based on their biologic risk of metastasis: Class 1 (low risk), Class 2A (moderate risk) or Class 2B (high risk).

“Incorporating DecisionDx-SCC test results into existing risk-assessment frameworks can give clinicians confidence that they are making informed and risk-appropriate decisions regarding the overall treatment intensity of their high-risk SCC patients,” says study investigator Sarah T. Arron, M.D., Ph.D., board-certified dermatologist and Mohs surgeon with Peninsula Dermatology in Burlingame, California, in a news release.  

In the study, 42 percent of Mohs surgeons reported greater confidence in their patient management decisions when using the personalized, risk-stratification information provided by DecisionDx-SCC test results.

A clinical impact survey was distributed to current American College of Mohs Surgery (ACMS) members; a total of 39 members provided responses to a variety of questions, including their familiarity with DecisionDx-SCC and their approach to a number of treatment modalities for a high-risk SCC patient, pre- and post-DecisionDx-SCC test results. Fully 97 percent of respondents were at least somewhat familiar with or had used the DecisionDx-SCC test. Several National Comprehensive Cancer Network (NCCN) high- or very-high risk factors, such as perineural involvement, lymphatic or vascular involvement, poor differentiation and more, that the clinicians believed were the most influential in the development of metastasis were also considered reasons to use DecisionDx-SCC.

Additionally, the survey highlighted a risk-appropriate trend where respondents’ overall approach to patient management intensity increased as the DecisionDx-SCC test results indicated an increased risk of metastasis and decreased when test results indicated a lower risk.