Knowing your Class can be extremely helpful to you and your doctor
DecisionDx™-UM measures the activity of 15 specific genes within your eye tumor to determine the likelihood of it spreading from the eye. The test identifies your prognosis as either Class 1A, Class 1B or Class 2, which represents the statistical risk of metastasis over five years, the period for which data has been collected.
This information can be extremely helpful to you and your doctor in planning your follow-up care. There are considerations about the kind and frequency of monitoring you will need, and whether you would be a candidate for certain treatments or even clinical trials as they become available.
Below are the potential test results, and the considerations for each:
These patients are at a very low risk of metastasis, with just a 2% chance of the eye cancer spreading over the next five years. Your doctor may recommend a less frequent monitoring program which might include bloodwork, office visit(s) and/or imaging such as X-ray, ultrasound, CT/PET or MRI.
These patients have a slightly higher risk of metastasis than those in Class 1A, or 21% over the next five years, but overall, are still considered low risk. However, to be on the safe side, your doctor may choose to monitor you more closely.
These patients are at high risk, with 72% risk of metastasis over the next five years.
If you have a Class 2 tumor, your doctor may recommend a high intensity program to monitor you for evidence of metastasis. This might include quarterly MRI or CT scans, along with quarterly liver function tests. Your doctor may also recommend referral to a medical oncologist for preventive treatment, and to review clinical trial opportunities. Results from molecular testing such as DecisionDx-UM will help determine whether or not you might qualify for such trials as they become available.
While the DecisionDx-UM test cannot, at this point, guide your doctor toward a specific therapy like chemotherapy, a recent study published in Clinical Ophthalmology, which involved doctor surveys and medical chart review of Medicare-treated patients, showed that molecular testing such as the GEP test has a significant impact on the management of uveal melanoma. Not only are most ophthalmologists treating uveal melanoma using molecular testing, but they are also more likely to increase frequency of disease monitoring or recommend clinical trials for those patients whose test results showed they were at high risk of metastasis.
Decisions about your surveillance, treatment and other follow-up plans should be made by you and your doctors.