What is the current role for genetic profile testing (e.g. DecisionDx-SCC) in the treatment paradigm for cutaneous malignancies?

This is a very cool test that has a lot of potential to help us make decisions in practice (full disclosure, I advise Castle and get research support from them, but am not directly compensated by them). The data published thus far shows that it is prognostic to predict nodal or distant mets. However...

Currently, the DecisionDx-SCC is best understood as prognostic but not predictive. This means that there is a lot of data supporting a correlation between the test score and the risk of metastases (mainly nodal). Some of this data can be found in the following publications:

Arron et al., PMID 340763...