The leader
in prognostic
melanoma testing

Not all melanoma GEP tests deliver the same clinical value. DecisionDx-Melanoma provides evidence-based insights across the patient journey—from SLNB decisions to recurrence risk.

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What is DecisionDx-Melanoma?

What is DecisionDx-Melanoma?

DecisionDx-Melanoma is the only melanoma gene expression profiling (GEP) test associated with improved survival.1

The test provides personalized results for patients with stage I-III cutaneous melanoma, guiding risk-aligned management decisions. By integrating the GEP score with traditional clinicopathologic features, DecisionDx-Melanoma results provide comprehensive results to answer two critical questions:

1

What is my patient's likelihood of sentinel lymph node (SLN) positivity?

The validated i31-SLNB algorithm integrates the 31-GEP score with specific clinicopathologic factors of Breslow thickness, ulceration, mitotic rate, and age. It provides a personalized risk assessment for the likelihood of having a positive node.

2

What is my patient's risk of recurrence or metastasis?

The validated i31-ROR algorithm integrates the 31-GEP score with specific clinicopathologic factors of Breslow thickness, ulceration, mitotic rate, SLN status, age, and binned tumor location. It provides a personalized 5-year outcomes for melanoma-specific survival, distant metastasis-free survival, and recurrence-free survival.

Two hikers holding hands on rocky terrain with a large lake and snow-capped mountains in the background.

Clinically validated in the largest real-world study of GEP testing in melanoma

[.underline-move-left]Recent data[.underline-move-left] from an ongoing collaboration with the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program show that DecisionDx-Melanoma testing was associated with lower melanoma-specific and overall mortality compared to untested patients. The study confirms DecisionDx-Melanoma delivers significant, independent risk stratification beyond AJCC8 staging.1

Independently validated. Clinically tested.

If you're going to use a GEP test in clinical practice, it's critical to ensure that the test provides clear, independent value beyond what's already freely and readily available to you today—namely, American Joint Committee on Cancer (AJCC) staging.

DecisionDx-Melanoma has nine peer-reviewed studies demonstrating consistent, independent performance – no other GEP test in melanoma has such evidence.

‍
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DecisionDx-Melanoma provides better risk stratification for patients with T1b-t2a tumors

Table comparing SLN positivity rates for Clinical Stage IB melanoma by DecisionDx-Melanoma and CP-GEP tests.

A subset of the prospective, multicenter DECIDE study patients with Stage IB (T1b-T2a) disease demonstrates that DecisionDx-Melanoma can:

  1. Low-risk patients well below the 5% NCCN low-risk threshold
  2. High-risk patients who are 13x more likely to be SLN-positive

In contrast, when it comes to CP-GEP, a low-risk result corresponds to a 5-10% risk threshold. Therefore, all patients should still be advised to "discuss and consider" the SLNB prodecure.4

*Low risk for DecisionDx-Melanoma defined as <5% i31-SLNB result & high risk defined as ≥10%

Read the full publication here

DecisionDx-Melanoma provides significant risk-stratification to inform management decisions

The visual on the right highlights the meaningful risk stratification between a Class 1A (lowest risk) and Class 2B (highest risk) DecisionDx-Melanoma result.

How does DecisionDx-Melanoma compare to other GEP tests?
Other GEP tests report a 74% recurrence-free survival (RFS) rate in their high-risk category, while reporting an 89% RFS in their low-risk population9. Notably, an 89% RFS is a threshold many oncologists would still consider the risk significant enough to warrant adjuvant therapy.10

I want to order DecisionDx-Melanoma
Chart showing class results and 5-year RFS prognosis: Class 1A lowest risk 96%, Class 2B highest risk 61%.

Expert Insights: Discover why Shannon Trotter, DO, FAOCD, FAAD, chooses DecisionDx-Melanoma and how it enhances patient management

DecisionDx-Melanoma — evidence + CTA sections

Castle Biosciences: The leader in melanoma prognostic testing leader with independent, robust validation and real-world results

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50+
peer-reviewed, published studies including prospective studies and two meta-analyses
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200k+
patients with a clinical DecisionDx-Melanoma order from ~13,000 clinicians
Medicare+
covered by Medicare and multiple private insurers with an industry-leading patient assistance program

*Numbers as of May 2025

Ensure you’re using DecisionDx-Melanoma—the most clinically evidenced GEP test—to guide management decisions for your melanoma patients

References

  1. Bailey et al. JCO PO. 2023
  2. Whitman et al. JCO PO. 2021
  3. Jarell et al. JAAD. 2022
  4. Guenther et al. World Journal of Surgical OncologyCancer Diagnosis & Prognosis. 2025
  5. Gerami et al. Clin Cancer Res. 2015
  6. Gerami et al. JAAD. 2015
  7. Zager et al. BMC Cancer. 2018
  8. Gastman et al. JAAD. 2019
  9. Eggermont et al. EJC. 2020
  10. Fastner et al. Cancer Medicine. 2023