Case Study

Prior to DecisionDx-Melanoma

• Brain MRI
• CT of chest, abdomen, pelvis
• PET scan
• SLNB - negative
• Consider adjuvant therapy

The patient received an MRI that was negative for metastatic disease and was sentinel lymph node negative. He did have multiple pulmonary nodules in the right lung, with the largest in the posterior right middle (9 mm), mildly enlarged hilar nodes and small indeterminate lung nodules that were deemed unlikely to represent metastatic disease. At the time of his diagnosis, only node positive (stage III) patients were eligible for adjuvant therapy.

Why DecisionDx-Melanoma?

Due to the thickness, ulceration, and high mitotic rate, the clinician felt that the patient had higher-risk tumor biology and ordered DecisionDx-Melanoma to help further characterize and finalize the decision to use adjuvant therapy.

Test result and impact to care

DecisionDx-Melanoma test result of Class 2B indicated the highest risk. The patient's RFS was 48% and the DMFS was 65%. The patient was referred to a medical oncologist and treated with off-label nivolumab for one year. Post-treatment surveillance with CT scans were performed every three months and a brain MRI annually for three years. The CT scans decreased to every four months starting in year four with a brain MRI performed annually. The patient also underwent routine dermatologic screening every six months.

The patient is doing well with clear scans at more than six years post-treatment.