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Castle Biosciences' Publications Featured in SKIN's 5-Year Anniversary Edition

SKIN presented their Five-Year Anniversary Special Edition Issue of SKIN, The Journal of Cutaneous Medicine® . This special issue included the top 20 most read articles in the journal’s five-year history that had the largest impact on clinical care.


One of these articles featured the analysis demonstrating the clinical value of DecisionDx-Melanoma in risk of recurrence thin tumors. A second article featured the initial development and validation study of DiffDx-Melanoma for use in patients with an ambiguous or difficult-to-diagnose suspicious pigmented skin lesion.


Development and Validation of a Diagnostic 35-Gene Expression Profile Test for Ambiguous or Difficult-To-Diagnose Suspicious Pigmented Skin Lesions

Sarah Estrada, Jeffrey Shackelton, Nathan Cleaver, Natalie Depcik-Smith, Clay Cockerell, Stephen Lencioni, Howard Martin, Jeffrey Wilkinson, Lauren Meldi Sholl, Michael Berg, Brooke Russell, Olga Zolochevska, Kyle Covington, Aaron Farberg, Matthew Goldberg, Pedram Gerami, Gregory Hosler


A clinical hurdle for dermatopathology is the accurate diagnosis of melanocytic neoplasms. While histopathologic assessment is frequently sufficient, high rates of diagnostic discordance are reported. The development and validation of a 35-gene expression profile (35-GEP) test that accurately differentiates benign and malignant pigmented lesions is described.


Total Views: 1,739

Establishing an Evidence-Based Decision Point for Clinical Use of the 31-Gene Expression Profile Test in Cutaneous Melanoma

Etan Marks, Hillary Caruso, Sarah Kurley, Sidra Ibad, Kristen Plasseraud, Federico Monzon, Clay Cockerell


Treatment plans for cutaneous melanoma are based upon individual risk of recurrence. Decisions made post-diagnosis include recommendation for a sentinel lymph node biopsy (SLNB), followed by management decisions such as surveillance, frequency of follow-up, and interdisciplinary consultations including possible adjuvant therapy use. These have traditionally been guided by clinicopathologic factors, but discordance exists, as a substantial number of melanoma deaths occur in patients diagnosed with disease considered to be early stage by such factors, including a negative SLNB.  Molecular testing can be used to apply an objective approach that optimizes individualized patient care.  The 31-gene expression profile (31-GEP) test has been validated in nearly 1600 patients as an independent predictor of risk of recurrence, distant metastasis and death in Stage I-III melanoma and can guide SLNB decisions in patient subgroups, as demonstrated in 1421 patients.  While clinical use of the 31-GEP test has been adopted into routine practice, an evidence-based analysis of a decision point for use in thin, T1 tumors would be clinically useful.  To help define an appropriate population for 31-GEP testing, we evaluated changes in patient management, cumulative differential risk across Breslow thicknesses based on a large dataset, and 31-GEP subclass distribution in a clinically tested cohort. Based on this, appropriate use of the 31-GEP test for management decisions was found to be in cutaneous melanoma tumors ≥0.3 mm thick.


Total Views: 1,622

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