A clinician listens to an elderly patient in her office


DecisionDx-Melanoma: A gene expression profile test for melanoma

Prognostic testing that provides comprehensive, personalized, information to guide management for patients with cutaneous melanoma  

How DecisionDx-Melanoma helps personalize your care

DecisionDx®-Melanoma is a genomic test that looks at your own tumor’s biology (usually from your original biopsy) to better understand your personal risk of your tumor spreading (metastasis), coming back (recurring or returning) within the next 5 years, and the chance of sentinel lymph node positivity (where melanoma often first spreads). DecisionDx-Melanoma has been validated in those with stage I-III melanoma.2

DecisionDx-Melanoma uses a small sample of your tumor (melanoma tissue) to measure the activity of 31 specific genes found to be associated with melanoma progression, specifically recurrence (cancer comes back) and metastasis (spreading). Based on your tumor’s activity levels, DecisionDx-Melanoma classifies your personal tumor as lowest risk (Class 1A), increased risk (Class 1B/2A), or highest risk (Class 2B).i

Generally, doctors give risk assessments based on cancer statistics from studies of people in similar situations (population statistics, or risk). These statistics describe what happens in groups of people defined by certain characteristics, such as age, biological sex, size of tumor. For melanoma, this includes measurements such as Breslow thickness, ulceration, and more.ii Because every patient's tumor is unique, with DecisionDx-Melanoma you get a personal risk assessment specific only to you.

Only 20% of people with malignant melanoma have melanoma in their sentinel node,iii sentinel lymph node biopsy (SLNB, the surgery to remove the node(s)) does not impact overall survival, and SNLB comes with certain risksiv that should be discussed with your doctor.

DecisionDx-Melanoma can help doctors determine you likelihood of needing a SLNB, or not, when added to clinicopathological features information (signs and symptoms you experience plus results of other laboratory studies and the review of melanoma tissue from your biopsy).1,3,v

For those with SLN-negative disease, results show if you are at high risk for recurrence or death from melanoma even though you are considered to be low risk by the traditional American Joint Committee on Cancer (AJCC) staging standards.1

DecisionDx-Melanoma results help you and your cancer care team make decisions about your treatment, follow-up appointments, referrals, and the sentinel lymph node biopsy (SLNB) surgical procedure. In fact, 1 out of every 2 people who get a DecisionDx-Melanoma test have a change made to their melanoma treatment plan for at least one of the following: frequency of doctor visits, lab work, or surveillance (monitoring) imaging.6

Backed by data and validated in real world practice


patients studied


peer-reviewed publications


technical success rate in 53,000+ clinical samples


patients tested since 2015


healthcare professionals have ordered the test


of clinical management plans change based on DecisionDx-Melanoma test results

DecisionDx-Melanoma – helping physicians and patients

  • How personalized medicine is showing that traditional views on staging may need to change and how DecisionDx-Melanoma is helping physicians better personalize care.

  • Click to play "Be Your Own Advocate: Morgan England, Stage III Melanoma Survivor, Shares Her Story" video

    Morgan’s Stage 2 melanoma diagnosis journey and how her DecisionDx-Melanoma test helps her manage her anxiety about her melanoma.

  • How doctors are using DecisionDx-Melanoma and how it helps them make decisions for those in their care who are living with melanoma.

Ask your doctor for DecisionDx-Melanoma — the GEP test that personalizes your risk assessment.

Coverage for DecisionDx-Melanoma

Castle Biosciences is committed to providing high-quality molecular testing to all patients. We do not want financial concerns to be a barrier to you accessing critical healthcare information.

We intend to work with all insurance providers, including Medicare, Medicaid, commercial insurers, and Veterans Affairs (VA), to secure payment coverage for our testing.

For those who may need additional assistance with with their Castle test, we offer a comprehensive patient assistance program.

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