Castle Biosciences, Inc. announced the publication of results from a study comparing and combining risk prediction using DecisionDx-Melanoma, the company’s gene expression profile (GEP) test used to predict risk of metastasis in cutaneous melanoma (CM) patients, and the American Joint Committee on Cancer’s (AJCC’s) clinical staging system using the Individualized Melanoma Patient Outcome Prediction Tool. The AJCC online prognostic tool is used by clinicians to estimate survival rates for patients with Stage I and II melanoma based on tumor depth, ulceration status, location and patient age to determine appropriate patient management. The paper, “Identification of High Risk Cutaneous Melanoma Tumors is Improved When Combining the Online AJCC Melanoma Patient Outcome Prediction Tool with a 31-Gene Expression Profile-Based Classification” was published in the Journal of the American Academy of Dermatology(JAAD). In the study, researchers found that when used in combination with the AJCC clinical staging system, DecisionDx-Melanoma can significantly improve the identification of those Stage I and II melanoma patients who have a high risk for recurrence and/or developing metastatic disease. Study investigators determined survival predictions by examining records from 205 Stage I and Stage II melanoma patients collected from six U.S. centers. AJCC clinical staging factors (Breslow thickness, ulceration, site of lesion, age and sentinel lymph node biopsy status) were entered into the AJCC Individualized Melanoma Patient Outcome Prediction Tool to attain predicted 5-year survival rates for each patient. Patients also received the DecisionDx-Melanoma GEP test, which provides a binary prediction of risk (Class 1 or Class 2) for melanoma recurrence, with refinement into subclasses (1A, 1B, 2A and 2B) that reflect proximity of risk to the crossover point between Class 1 and Class 2. The cohort included 109 Stage I and 96 Stage II cases. To compare risk prediction from the AJCC clinical staging system to the binary GEP prediction of risk, five-year survival rates of 79% and 68% were used as cutoff scores to separate patients into low risk and high risk groups. These cutoff scores reflect the 5-year survival rates for Stage IIA or IIB patients, respectively, and are used to identify cohorts of patients who can receive significantly different surveillance and therapeutic opportunities based upon national treatment guidelines and center-specific management strategies for Stage II patients.