Castle Biosciences Shows 5-Year Risk Prediction Improvement in 1,817 Melanoma Patients

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Castle Biosciences will present data on DecisionDx-Melanoma from 1,817 stage I–III patients showing a 5-year recurrence risk prediction improvement beyond AJCC staging, identifying early-stage patients whose recurrence risk matches higher-stage disease. SEER analysis of T1a/T1b cases found molecularly high-risk patients with lower 5-year melanoma survival, underscoring need for precise management.

1. New Multi-Center Cohort Results

Data from a cohort of 1,817 stage I–III cutaneous melanoma patients demonstrate that combining DecisionDx-Melanoma molecular profiling with AJCC staging significantly improves 5-year recurrence risk prediction. The test identified early-stage patients whose recurrence rates were comparable to those with stage IIB–IIIA disease, revealing risk nuances not captured by staging alone.

2. SEER Registry Analysis

Analysis of population-based SEER registry data for T1a and T1b melanoma patients showed that DecisionDx-Melanoma can stratify thin tumors by molecular risk. High-risk T1 patients exhibited significantly lower 5-year melanoma-specific survival, indicating that molecular profiling can uncover patients at elevated risk despite low-stage classification.

3. Implications for Clinical Management

These findings support the use of DecisionDx-Melanoma to guide more precise, risk-aligned care decisions such as sentinel lymph node biopsy consideration, surveillance intensity adjustments and multidisciplinary referrals. The personalized prognostic information aligns with guideline thresholds and may improve outcomes by identifying patients who benefit from intensified management.

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