FRIENDSWOOD, Texas, October 1, 2026
Castle Biosciences, Inc. announced late-breaking data presented at the European Academy of Dermatology and Venereology (EADV) 2026 Congress supporting the use of its DecisionDx®-Melanoma gene expression profile in clinical decision-making for patients with cutaneous melanoma. The data examined how the test may contribute to decisions surrounding sentinel lymph node biopsy (SLNB) and subsequent post-surgical management by providing individualized information about a patient’s risk of melanoma recurrence or metastasis. DecisionDx-Melanoma analyzes the expression of genes in a melanoma tumor to classify patients according to their risk of recurrence and metastasis. Castle Biosciences said the EADV findings add to the growing body of clinical evidence supporting the integration of molecular risk assessment with traditional clinicopathologic factors when physicians evaluate melanoma patients. The company presented multiple analyses highlighting potential applications of DecisionDx-Melanoma in treatment planning and risk-aligned surveillance following surgery.
DecisionDx-Melanoma Supports SLNB Decision-Making
One of the key areas examined in the EADV data was the potential role of DecisionDx-Melanoma in sentinel lymph node biopsy decision-making. SLNB is commonly considered for patients with certain characteristics of primary melanoma to determine whether melanoma cells have spread to nearby lymph nodes. However, not every patient has the same risk of regional or distant metastasis, creating a need for tools that can provide additional individualized information. DecisionDx-Melanoma evaluates the biological behavior of the tumor using a 31-gene expression profile and categorizes patients according to their risk of recurrence or metastasis. Castle Biosciences reported that the data presented at EADV demonstrated how test results could complement existing clinical and pathological information when physicians consider whether SLNB may be appropriate. The company said these findings support the potential value of incorporating molecular information into individualized melanoma management strategies.
Risk-Aligned Management After Melanoma Surgery
The EADV presentations also evaluated the potential use of DecisionDx-Melanoma results in post-surgical management. Following removal of a primary melanoma, patients can have different levels of risk for recurrence or metastasis, even when tumors share similar traditional clinical characteristics. Molecular risk information may provide clinicians with an additional layer of evidence when determining the intensity of surveillance and follow-up. Castle Biosciences reported that patients classified by DecisionDx-Melanoma as having different risk profiles could potentially receive risk-aligned management, helping clinicians consider follow-up strategies based on an individual patient’s estimated biological risk. The company emphasized that the test is intended to complement, rather than replace, established clinicopathologic assessment. Such approaches are particularly relevant in melanoma because recurrence can occur after apparently successful surgical removal, and identifying patients at increased risk can inform decisions about monitoring and subsequent care.
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Molecular Testing Expands Precision Melanoma Care
DecisionDx-Melanoma is a molecular diagnostic test developed to provide prognostic information for patients diagnosed with cutaneous melanoma. By examining gene-expression patterns within the tumor, the test generates a risk classification intended to help physicians better understand an individual patient’s likelihood of recurrence or metastasis. The EADV 2026 findings add to Castle Biosciences’ ongoing efforts to demonstrate the clinical utility of molecular diagnostics in personalized cancer management. Melanoma treatment and follow-up decisions traditionally incorporate factors such as tumor thickness, ulceration, mitotic activity, and lymph-node status. Molecular testing can provide additional biological information that may be considered alongside these established factors. Castle Biosciences said the late-breaking EADV data support the use of DecisionDx-Melanoma in both SLNB decision-making and risk-aligned post-surgical management, potentially helping clinicians tailor care according to the biological characteristics of each patient’s melanoma. The findings remain clinical evidence supporting use of the diagnostic and do not mean that molecular testing should replace established clinical judgment or guideline-based care.
Source: Castle Biosciences press release
