NPs and PAs Value Prognostic Information From DecisionDx-Melanoma

Fully 82.4% of respondents who use DecisionDx-Melanoma in clinical practice stated that a high-risk test result in a thin melanoma tumor would impact their patient treatment plan; similarly, 81.3% of test users would alter treatment plans based on a high-risk test result in Stage 1 tumors.

More than 90% of nurse practitioners and physician assistants(NPs/PAs),   agree that prognostic information about a patient’s melanoma is valuable and improves patient care, , according to new study looking at use of DecisionDx-Melanoma in the Journal of the Advanced Practitioner in Oncology.

Castle’s DecisionDx-Melanoma is a gene expression profile risk stratification test that is designed to inform a patient’s individual risk of sentinel lymph node (SLN) positivity and a patient's personal risk of melanoma recurrence and/or metastasis. 

For the study, NPs and PAs who attended one of three selected conferences in 2020 and 2021 were asked to complete an 18-question online survey about their viewpoints and clinical use of DecisionDx-Melanoma. Of the 369 NPs/PAs who completed the survey, 176 (47.7%) reported using the DecisionDx-Melanoma test in the prior 12 months. Fully 90.5% of the respondents felt that comprehensive prognostic testing, such as with DecisionDx-Melanoma, improves patient care.

The majority of DecisionDx-Melanoma test users stated that they used the test results to determine follow-up schedules and referrals (78.4%), inform treatment decisions (65.9%), as part of the decision to decision to recommend a patient receive or forego sentinel lymph node biopsy (SLNB) (61.9%) and inform surveillance imaging (50.0%), the study showed.

Additionally, almost all test users would recommend use of DecisionDx-Melanoma to a colleague (99.4%) or a friend or close relative who had been diagnosed with melanoma (97.7%); interestingly, most NPs/PAs who had not used DecisionDx-Melanoma would also recommend use of the test to a colleague (81.9%) or a friend or close relative with melanoma (62.7%). The value of both high-risk (Class 2B) and low-risk (Class 1A) DecisionDx-Melanoma test results were reported by all of the NPs/PAs who completed the survey (test users and non-users):

Most (62.1%) reported that a high-risk DecisionDx-Melanoma test result would alter their treatment plan for a patient with a thin tumor (≤1mm). Similarly, more than half of all respondents (58.8%) stated that a high-risk test result would alter their treatment plans for patients with a Stage 1 tumor.

When asked if there was value in a T1 patient receiving a low-risk result (i.e., test results confirming a low-risk tumor according to clinicopathologic staging), 74.5% indicated that patients would benefit from relief of uncertainty about their cancer, and 56.9% responded that providers would benefit from more confidence in their chosen treatment plan.

“Historically, patients with thin or Stage 1 tumors would be considered to be at the lowest risk of metastasis or recurrence, based on traditional staging factors alone,” says Renata Block, MMS, PA-C, first study author and board-certified physician assistant at Advanced Dermatology & Aesthetic Medicine, LLC in Chicago, in a news release. “As the study data affirmed, the personalized, clinically actionable results provided by DecisionDx-Melanoma can significantly impact the treatment plans of patients with melanoma, particularly in the 'low-risk' patient population when their test results indicate aggressive tumor biology that would place them at a higher risk of a poor outcome.”