What do you prioritize when a patient has discordant clinicopathologic features and genomic risk scores to estimate melanoma recurrence risk?

At this time, the test to assess genomic risk score (i.e., Castle DecisionDx) is based on retrospective analysis, and there are no prospective data yet. So it should not be used solely for decision-making, especially when it comes to whether to do adjuvant systemic therapy or not. The traditional Am...

For patients that have a high genomic risk score and a low stage, I prioritize the genomic risk. We know that about a quarter of melanoma metastases occur from low-stage disease, and I increase surveillance on these patients. Precision medicine allows us to ensure we catch these bad actors before th...

The DecisionDx score incorporates clinical-pathologic features into the genomic risk assessment. The gene expression score has been validated independently, but it has also been validated alongside clinical-pathologic factors such as ulceration, age, tumor depth, and mitotic rate. Those features are...