AR-V7 test

[dhccpa]

Has anyone had the AR-V7 test done? It supposedly can indicate whether Zytiga, Xtandi, or chemo would be most useful (or not) to a patient. I wondered if Medicare covers it.

oncotypeiq.com/en-US/prosta...

[Tall_Allen]

I never saw any purpose to it - Why not just take Zytiga? It will either work or it won't.

[dhccpa in reply to Tall_Allen]

I see your point, TA. But what is your definition of Zytiga working? My PSA in 2021 has been 0.5-0.6, the lowest in my three years on Lupron only. For Zytiga to work, would it have to lower PSA below 0.5? Or some other factor?

Thanks

[Tall_Allen in reply to dhccpa]

It would have to prevent PSA from rising.

[dhccpa in reply to Tall_Allen]

My PSA hasn't really risen in three years on Lupron, with one short exception.

Then I don't see how I could know if Zytiga is working during any initial period of use.

Any other objections to the test?

[Tall_Allen in reply to dhccpa]

Why are you starting on abiraterone? I don't see your diagnosis in your profile. Are you metastatic? If so, why haven't you started abiraterone before? If not, is it because of the recent M0 STAMPEDE trial. If the latter, the benefit was seen w/o the AR-V7 test. AR-V7 is a rare mutation.

[dhccpa in reply to Tall_Allen]

Keep in mind that I was inquiring what people knew about the test; I just became aware of it.

When I was diagnosed, I was put on Lupron only. Within the first year, I was made aware of the Zytiga angle. However, the oncologists I consulted, five in all, were split on whether I should add it. This was at UF, Moffitt, and Mayo JAX.

I am metastatic. My local oncologist has been neutral on adding it (or doing chemo), but we're due to discuss again late this month.

[ctflatlander in reply to dhccpa]

I had the test done in May of 2019 at the John Hopkins Lab. It was done from a Vt lab using Fed X and their special container. My results were that there was no CTC's therefore the AR-V7 status could not be assessed. Based on their literature, negative CTC's in their blood circulation had the best outcome to both enzalutamide and abiraterone. It was covered by Medicare. The special cold container, blood draw, overnight postage was not covered. This was 2 1/2 years ago so I hope it still holds true.

[dhccpa in reply to ctflatlander]

Thanks for the info.

[Tall_Allen in reply to dhccpa]

It is SOC now, but maybe it was too new back then.