Castle Biosciences, Inc.’s DecisionDx-SCC test improves risk stratification of patients with cutaneous squamous cell carcinoma (SCC) tumors located on the head or neck when the test’s results are combined with Brigham and Women’s Hospital (BWH) staging, new research shows.
The new study was selected as a late breaker top five finalist for the best poster Akamai Award at the 2025 Maui Derm Hawaii meeting.
DecisionDx-SCC is a 40-gene expression profile test that uses an individual patient’s tumor biology to stratify risk of metastasis in SCC patients who have one or more National Comprehensive Cancer Network (NCCN) high-risk factors. The test result, in which patients are stratified into a Class 1 (low), 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.
The new study included data on 1,408 patients with SCC to date, the largest cohort to date. DecisionDx-SCC was a significant predictor of metastasis, with distinct three-year metastasis-free survival rates provided across its risk classes: Class 1 (92.3%), Class 2A (81.3%), and Class 2B (57.8%). Further, combining DecisionDx-SCC test results with BWH staging significantly improved the accuracy of metastatic risk prediction which can help clinicians and patients make more informed and risk-aligned management decisions, the study showed.
“Patients with SCC tumors of the head or neck may be at increased risk of metastasis and thus could be candidates for adjuvant treatments, such as radiation, to reduce this risk,” says Emily Ruiz, MD, MPH, FAAD, a dermatologist and Mohs micrographic surgeon at Brigham and Women’s Hospital in Boston, and Associate Professor of Dermatology at Harvard Medical School in Boston, MA, in a news release. “As demonstrated in the study, using the DecisionDx-SCC test alongside BWH staging improved the overall accuracy of metastatic risk predictions in patients with these higher-risk SCC tumors to further inform decisions that clinicians make with their patients regarding the appropriate treatment aligned to their risk of metastasis.”
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