On May 29, 2024 Castle Biosciences, Inc. (Nasdaq: CSTL), a company improving health through innovative tests that guide patient care, reported the publication of a study in the International Journal of Radiation Oncology • Biology • Physics (Red Journal) demonstrating the ability of the DecisionDx-SCC test to identify high-risk cutaneous squamous cell carcinoma (SCC) patients at the highest risk of metastasis who will benefit the most from ART to reduce metastatic disease progression, as well as high-risk patients who the test identified as having a lower risk of metastasis who may consider deferring treatment (Press release, Castle Biosciences, MAY 29, 2024, View Source [SID1234643822]). These results demonstrate the impact of the test in guiding decision-making for recommending ART.
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"Radiation may be considered for patients with more aggressive SCC tumors to reduce the risk of the cancer returning once the tumor has been removed through surgery," said Sarah T. Arron, M.D. Ph.D., lead author and board-certified dermatologist and Mohs surgeon at Peninsula Dermatology in Burlingame, California. "When relying on current risk assessment and staging systems alone, it can be very challenging to determine for which patients with high-risk SCC the benefits of radiation therapy outweigh the significant side effects and associated impacts on the patient’s quality of life.
"The study found that DecisionDx-SCC test results can assist clinicians in making these difficult decisions by identifying which patients are most likely to benefit from the treatment."
Key findings of the study (n=920 patients) include:
The DecisionDx-SCC test identified patients projected to receive the greatest benefit from ART to reduce metastatic disease progression. Patients with a Class 2B (highest metastatic risk) test result who were treated with ART had 50% higher MFS rates, on average, than Class 2B patients who did not receive ART at five years post-diagnosis.
A DecisionDx-SCC Class 2B result was the only independent risk factor that successfully identified patients who would most benefit from ART. Risk factors in the analysis included differentiation status, invasion into fat, perineural invasion and others, including National Comprehensive Cancer Network (NCCN) risk category and Brigham and Women’s Hospital and American Joint Committee on Cancer Eighth Edition T-stages.
Class 2B patients who received ART showed a significant deceleration in disease progression compared to Class 2B patients who did not receive ART. For patients with a DecisionDx-SCC Class 2B test result who were not treated with ART, there was a peak rate of metastasis around two years; Class 2B, ART-treated patients had nearly five times longer projected time to metastasis.
DecisionDx-SCC identified patients who were less likely to show a significant benefit from ART in controlling disease progression. Patients with high-risk clinicopathologic features but who received a DecisionDx-SCC Class 1 (lower metastatic risk) test result did not show a significant benefit from ART. Given the low risk of metastasis for Class 1 patients, in addition to the lower likelihood of ART benefit, Class 1 patients may consider deferring treatment.
About DecisionDx-SCC
DecisionDx-SCC is a 40-gene expression profile test that uses an individual patient’s tumor biology to stratify risk of metastasis in patients with cutaneous squamous cell carcinoma who have one or more NCCN high-risk factors. The test result, in which patients are stratified into a Class 1 (lower), Class 2A (higher) or Class 2B (highest) risk category, predicts individual metastatic risk to inform risk-appropriate management and guide decision-making regarding the use of adjuvant radiation therapy. Peer-reviewed publications have demonstrated that DecisionDx-SCC is an independent predictor of metastatic risk and that the test can significantly improve risk-stratification when used with traditional staging systems and clinicopathologic risk factors to guide risk-aligned management and treatment decisions. Learn more at www.CastleBiosciences.com.