DecisonDx-SCC – pro
Current National Comprehensive Cancer Network (NCCN) guidelines [5] recommend treatment strategies based on broad criteria for identifying a high-risk SCC patient (those with a single clinicopathologic risk factor). A prognostic 40-gene expression profile (40-GEP) test, clinically available as DecisionDx-SCC, has been developed and validated to show improved stratification of metastatic risk in high-risk SCC patients compared to current staging systems alone. Validation studies support the test, but it has not been shown prospectively to provide clicnal benefit, and no guidelines currently recommend it.
Borman S, Wilkinson J, Meldi-Sholl L, Johnson C, Carter K, Covington KR, Fitzgerald AL, Kurley SJ, Farberg AS, Goldberg MS, Monzon FA, Oelschlager K, Cook RW. Analytical validity of DecisionDx-SCC, a gene expression profile test to identify risk of metastasis in cutaneous squamous cell carcinoma (SCC) patients. Diagn Pathol. 2022 Feb 25;17(1):32. doi: 10.1186/s13000-022-01211-w. PMID: 35216597; PMCID: PMC8876832.
Wysong A, Newman JG, Covington KR, Kurley SJ, Ibrahim SF, Farberg AS, Bar A, Cleaver NJ, Somani AK, Panther D, Brodland DG, Zitelli J, Toyohara J, Maher IA, Xia Y, Bibee K, Griego R, Rigel DS, Meldi Plasseraud K, Estrada S, Sholl LM, Johnson C, Cook RW, Schmults CD, Arron ST. Validation of a 40-gene expression profile test to predict metastatic risk in localized high-risk cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2021;84(2):361–369. doi: 10.1016/j.jaad.2020.04.088.
Farberg AS, Hall MA, Douglas L, Covington KR, Kurley SJ, Cook RW, et al. Integrating gene expression profiling into NCCN high-risk cutaneous squamous cell carcinoma management recommendations: impact on patient management. Curr Med Res Opin. 2020;18:1–7. doi: 10.1080/03007995.2020.1763284.
NCCN Skin Cacner 2025