Question about new test – DecisionDx by Castles Biosciences Inc.

Sorry about the link, it is not for the same test that you are asking about, I looked back and couldn't find them any more. There was a couple of post by new posters trying to sell the product. I think the post have been removed, but not 100% sure on that. Ed

My Derm also recommended Castle test at my May appt. I agreed since it was no cost to pt at this time, and my result (2b, highest risk) came in about 3 weeks.

My lesion was already considered high risk because of depth and mitotic rate so not much change except to stay diligent in checks with onc and derm every 3 mo, and cautioned me not to ignore anything that could be symptom of mets. I believe they also decided to extend the duration of time for frequent monitoring. I will be a year from diagnosis in July. 

Honestly it did ramp up my anxiety a bit. I did a fair bit of reading, but all the articles seem to be from Castle so taking with grain of salt. They must be marketing the heck out of it though. 

"Castle Biosciences closed the first tranche of a $20 million Series F round, roping in $11.7 million to ramp up marketing for its cutaneous melanoma test and R&D for its cancer diagnostic tool" http://www.fiercebiotech.com/medical-devices/castle-biosciences-reels-11m-for-cancer-dx

I don't think Insurance companies are buying it though. If you google you will find some plan evaluations categorizing it as experimental, not covered. 

It might feel reassuring to get a lower risk classification, but it's still a statistical thing and one could fall on either side of the split either way. Also one might benefit from increased diligence if a low risk lesion (by depth) came back w high risk genetically from Castle.

I would not sign anything agreeing to pay if insurance doesn't cover. My understanding is Castle is not billing patients but I did see one post here about someone getting billed, but I think ultimately did not pay.

Castle Biosciences has offered for some time an evaluation of primary tissue in ocular melanoma that is highly predictive of the likelihood of metastasis. The test looks at genetic profiles of patients. Those profiles fall into two broad classes: Class I patients rarely experience metastasis and Class II patients almost always experience metastasis. Castle now has a similar product for cutaneous melanoma. So far they have only done small studies, but the test seems to hold up well. They tested a group of Stage I and II melanoma patients. Those who tested as Class 1 had a 5-year metastasis-free rate of 97%; those who tested Class II were at 31%. They also looked at patient who had sentinel-node biopsy (SLNB). In that study, the Castle test was more accurate than SLNB than predicting response. (From mpip info on tests)