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Genomic Test Predicts Risk of SCC Metastasis

By LabMedica International staff writers
Posted on 27 Nov 2025

Managing squamous cell carcinoma (SCC) of the skin in patients with one or more risk factors is a significant clinical challenge, especially as SCC-related deaths are now estimated to exceed those from melanoma. More...

Since treatment and management plans rely heavily on the risk of local recurrence and metastasis, accurate prognostic information is essential for guiding care. However, traditional clinicopathological risk factors alone are often insufficient to determine risk-appropriate treatment and management strategies for SCC. Now, a novel genomic test accurately identifies the risk of metastasis in high-risk SCC patients and also predicts which patients are most likely to benefit from adjuvant radiation therapy (ART)

The DecisionDx-SCC genomic test from Castle Biosciences (Friendswood, TX, USA) examines the tumor biology of SCC of the skin to better understand the risk of cancer spreading to other parts of the body. The validated 40-GEP test is designed to identify the risk of nodal or distant metastasis in SCC patients with at least one high-risk feature, based on the biological profile of 40 genes within their tumor tissue.

In addition to being the strongest independent predictor of SCC metastasis, DecisionDx-SCC is shown to be a significant predictor of local recurrence, adding prognostic value to support tailored post-surgery management decisions. The test also identifies which patients are most likely to benefit from ART. Test results deliver precision patient classification, complementing commonly used traditional risk factors and improving risk assessment in SCC to inform key clinical management decisions.

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