Derm Dispatch: Physician Assistants Advance Clinical Trial Research

In the latest Derm Dispatch episode hosted by Renata Block, DMSc, MMS, PA-C, Andrew Baker, PA-C, MBA, discussed his role as a sub-investigator in Castle Biosciences’ UTILISE study, marking his first opportunity in clinical research and a significant milestone for physician assistants (PAs) in dermatologic oncology.

Baker, who practices at DOCS Dermatology in Columbus, Ohio, discussed the importance of advancing individualized care for patients with cutaneous squamous cell carcinoma (cSCC). Given the high prevalence of non-melanoma skin cancers, particularly cSCC, and the small but serious subset of cases that metastasize, the need for enhanced risk stratification is critical.

The UTILISE trial, also known as the “Clinical Utility and Health Outcome Study” of the DecisionDx-SCC prognostic genetic expression profile test, is designed to evaluate how Castle Biosciences' gene expression profiling (GEP) test for cSCC impacts real-world clinical decision-making.¹ Baker explained that the test has been commercially available for approximately 3 years and categorizes patients as low-, moderate-, or high-risk based on tumor biology. The goal of the study is to assess how these GEP results influence management decisions before and after clinicians receive them, as well as to gather outcomes data from a broader patient registry.²

“Shared decision-making is and should be a large part of what clinicians do. Whether a patient has a very low risk or very high risk, I believe that all of us have been asked by a patient, ‘Is this going to spread? Is this going to come back? Is this going to cause my demise?’ This is just another option in the clinician's toolbox to better be able to provide those answers and treat the patients,” Baker said.

Baker's involvement in the UTILISE study is not only professionally meaningful but also a look at the evolving role of PAs in research. He noted that while PAs are increasingly serving as principal investigators in oncology studies, their presence in dermatology trials remains limited. He hopes his participation will inspire other advanced practice providers to pursue research opportunities and engage industry in conversations about expanding investigator eligibility.

Baker credited his early career exposure at an academic cancer institute for sparking his interest in research and emphasized that clinicians don’t need prior trial experience to get started.

“One person that I think physician assistants should utilize is their medical science liaison. I think they're invaluable in giving you that information,” Block added. “If you want to speak to someone in industry, then have your representative connect you with the MSL, and you can continue that conversation.”

The UTILISE study is ongoing, with Baker already enrolling patients earlier this year. As the dermatology community continues to embrace precision medicine, Baker’s work highlights the value of incorporating PA-driven research leadership into continued skin cancer management.

References

1. Castle Biosciences presents new data demonstrating the impact of DecisionDx-SCC test results on the management of Medicare-eligible patients with cutaneous squamous cell carcinoma and one or more risk factors. News release. Castle Biosciences. October 24, 2022. Accessed June 30, 2025. https://ir.castlebiosciences.com/news/news-details/2022/Castle-Biosciences-Presents-New-Data-Demonstrating-the-Impact-of-DecisionDx-SCC-Test-Results-on-the-Management-of-Medicare-Eligible-Patients-with-Cutaneous-Squamous-Cell-Carcinoma-and-One-or-More-Risk-Factors/
2. Hooper PB, Farberg AS, Fitzgerald AL, et al. Real-world evidence shows clinicians appropriately use the prognostic 40-gene expression profile (40-gep) test for high-risk cutaneous squamous cell carcinoma (cSCC) patients. Cancer Invest. 2022 Nov;40(10):911-922. doi: 10.1080/07357907.2022.2116454