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Home » Personalized Medicine » How a Genomic Test Is Empowering Better, More Personalized Melanoma Care

The DecisionDx®-Melanoma genomic test allows for more informed, risk-aligned decision-making and is associated with improved patient outcomes.

Dr. Aaron Farberg

Chief Medical Officer, Bare Dermatology

“This test provides a patient with information that can give them a better chance of survival.”

If you’ve been diagnosed with invasive melanoma, you probably have a lot of questions. The first one may be, “What happens next?”

“The first thing we’re going to do is gather all the information we can about the patient and their unique melanoma,” said Dr. Aaron Farberg, a double board-certified dermatologist and dermatologic surgeon, and the chief medical officer of Bare Dermatology in Dallas.

One of the best tools for gathering that information, Dr. Farberg says, is the DecisionDx-Melanoma genomic test from Castle Biosciences. The test analyzes tissue from the patient’s melanoma to check for activity of 31 specific genes that can provide insight into risk of metastasis and recurrence.

Physicians analyze the results of the test alongside other risk factors (e.g., Breslow thickness, tumor ulceration, mitotic rate, patient age) to evaluate the patient’s overall risk and help develop an appropriate plan for treatment and management.

“This is personalized medicine, personalized oncology, individualized care,” Dr. Farberg said. “This test provides a patient with information that can give them a better chance of survival.”

Multiple studies support Dr. Farberg’s claim. A study published in collaboration with the National Cancer Institute’s SEER Program Registries found that testing with DecisionDx-Melanoma was associated with higher three-year survival rates for patients,1 and another study found that patients who received the genomic test received their recurrence diagnosis about 10 months earlier than those who did not, enabling them to make more informed health decisions more quickly.2

Patient story

Morgan England

Melanoma Survivor

“I read through that test report and it makes me feel better. It’s been a way that I have coped with anxiety in this diagnosis.”

Morgan England is one of many patients who was able to make better treatment decisions thanks to DecisionDx-Melanoma. In July 2021, she noticed that a mole she had always had on her arm became raised and was changing over the course of several months.

After multiple doctors told her not to worry about it, the mole eventually started to bleed. Her dermatologist had it removed and a week later told England she had Stage 2 melanoma.

“I knew it was cancer,” said England, 31. “I knew it was bad, but I didn’t know how bad.”

She began researching the condition and determined that she wanted to get the DecisionDx-Melanoma genomic test to give her better insight into her cancer. She asked her doctor to order the test, and England fell into the Class 2A risk group.  

“2A — it’s not the worst,” England said. “But it’s not the best, either.”

The DecisionDx-Melanoma test results meant she had a 20% chance of having a positive sentinel lymph node, meaning the cancer may have spread, or metastasized, beyond her primary tumor.

Morgan underwent a sentinel lymph node biopsy surgery, where it was discovered that she had a positive sentinel lymph node. Based on that result, she started treatment, including a daily medication to target a mutation in the melanoma to reduce her risk of recurrence. Now two years later, Morgan is still cancer free.

“I read through that test report and it makes me feel better,” she said. “It’s been a way that I have coped with anxiety in this diagnosis.”

Better data, better decisions

For physicians who have not yet started utilizing DecisionDx-Melanoma, Dr. Farberg asks them to put themselves in their patients’ loved ones’ shoes.

“This test unequivocally helps your patients with invasive melanoma, so I urge you — do the right thing,” he said. “If this was your mom, your dad, you’d be ordering this test. Go through the extra steps and do this for your patients, too.”

As a patient, you need to know what resources are available and collaborate with your care team to receive the best care. And when it comes to invasive melanoma, DecisionDx-Melanoma is a critical resource you and your team should be aware of.

“Your health is your own,” England said. “You have to be your own advocate.”

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[1] Bailey C, Martin B, Petkov V, Schussler N, Stevens J, Bentler S, Cress R, Doherty J, Durbin E, Gomez S, Gonsalves L, Hernandez B, Liu L, Morawski B, Schymura M, Schwartz S, Ward K, Wiggins C, Wu X, Goldberg M, Siegel J, Cook R, Covington K, Kurley S. 31-Gene Expression Profile Testing in Cutaneous Melanoma and Survival Outcomes in a Population-Based Analysis: A SEER Collaboration. JCO Precision Oncology 2023.

[2] Dhillon S, Duarte-Bateman D, Fowler G, Hagstrom MNE, Lampley N, Olivares S, Fumero-Velázquez MS, Vu K, Wayne JD, Gastman BR, Vetto J, Gerami P. Routine imaging guided by a 31-gene expression profile assay results in earlier detection of melanoma with decreased metastatic tumor burden compared to patients without surveillance imaging studies. Arch Dermatol Res. 2023 Oct;315(8):2295-2302. doi: 10.1007/s00403-023-02613-6. Epub Mar 28, 2023. Erratum in: Arch Dermatol Res. Apr 12, 2023: PMID: 36977840.

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