Castle Biosciences, a company developing tests that guide patient care, announced the publication of a study in the Journal of the Advanced Practitioner in Oncology (JADPRO) that assessed the viewpoints of nurse practitioners and physician assistants toward the clinical use of DecisionDx-Melanoma in patients diagnosed with cutaneous melanoma. 

The study found that more than 90% of the nurse practitioners and physician assistants who completed a survey about DecisionDx-Melanoma believe that prognostic (i.e., risk-stratification) information about a patient’s melanoma is valuable and improves patient care. The study is available here.

“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. “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.”

Further reading: New Study Shows Efficacy of Castle Biosciences Barrett’s Esophagus Test

Study methods and findings:

  • Nurse practitioners and physician assistants 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 nurse practitioners and physician assistants who completed the survey, 176 (47.7%) reported using the DecisionDx-Melanoma test in the prior 12 months.
  • 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%).
  • 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 nurse practitioners and physician assistants 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 nurse practitioners and physician assistants 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.