I have tried three times to get my husband's MO to request an AR-V7 test. The doctor says that since hubby progressed on both Abiraterone and Xtandi the test is useless.
I mentioned re-challenge after chemo but he ignored me.
Is this worth seeing another doctor for a second opinion? How valuable is testing for AR-V7 after failure of Abiraterone and Xtandi?
Thank you Nalakrats. At this point the options are very limited so I'm willing to take a 25% chance that a re-challenge might work.
Hubby has only done the Color test, which showed no genetic defects. We live in Western Washington, out in one of the remote island communities. The doc I would very much like to get an appointment with is Dr. Heather Cheng: she is the Director of Prostate Cancer Genetics at Seattle Cancer Care Alliance.I think she could give us a comprehensive analysis & range of options.
Great choice to see new dr in Seatle. Go for it.. At worst she can't help. At best more years with you...
I don't think it's at all valuable. There are many more resistance mechanisms than AR-V7. Zytiga or Xtandi either work or they don't - take a pill and see.
So there's no benefit to a re-challenge after docetaxel?
You can try to re-challenge, but you don't need the test.
OK, thank you for the clarification.
Sometimes we aren't lucky enough to be blessed with seconds chances. Please strongly consider receiving a second opinion.
Hidden thank you, just sent off the request!
The purpose of any test is to help inform treatment decisions.
It sounds like the next treatment would be first-line Docetaxel chemotherapy or second-line Cabazitaxel if he's had Docetaxel already. Both of those have been proven to be effective with AR-V7.
Genetic sequencing could still have some value though to check for somatic mutations that have treatments available such as BRCA1, BRCA 2 and ATM.
Yes go see Cheng at SCCA. You will get good guidance. I would want the AR-V7 test. There are emerging regimens to deal with it and she will know about the options. Don’t just settle for SOC.
Is Cheng the top MO at SCCA in your opinion?
I consulted with Dr Tia Higano but I think she is no longer taking new patients. So Cheng may be tops now.
Yes, I heard Dr. Higano is not seeing patients any longer, focusing on research.
Need Info on AR-V7 Gene
Oncotype DX AR-V7 Test Approved for Coverage by Medicare
Turning OFF the AR-V7 Gene Splice.
Are all AR inhibitors the same?
Can melatonin control AR amplification and therefore help mCRPC drugs work better and longer? 
