Epic SCIENCES’ CTC-based liquid-biopsy test for AR-V7

[podsart]

Wondering if anyone had any interaction/knowledge of EPIC Sciences regarding this test.

What the requirements for approval/payment by medicare/medicare advantage patients? What does it cost? Do they have a "surprise billing protection provision like Guardant360 has?

Is there a minimal PSA level needed to make this test valid?

Of those that have used it, how "actionable" were the findings; under what conditions?

[Tall_Allen]

Why do you want it? Why not just try Zytiga?

[podsart in reply to Tall_Allen]

Discussed with Dr Drake using the Guardant360 to see what genetically changed if the 5/31/22 1st non detectable Psa since Feb 2016 is confirmed/increased. Dr Drake said that a CTC-ARV7 test would be more actionable.

He also said insurance has become more difficult. Guardant has a "surprise bill process" , so if after insurance is addressed, they will call you if the bill looks bigger than $100 before they proceed, so you dont suddenly end up with a bill in the thousands $$. I was wondering re cost of ARV7 cost and whether they have such a "surprise bill" opt out.

Understand frequently resistance to Xtandi is related to a mutation of the AR, so CTC-ARV7 test made sense.

I read that if Xtandi resistance is reached, there is high degree of cross resistance to Zytiga. I have some memory that an AR mutation would also affect Zytiga. However, he did say he would consider trying Zytiga if the next test showed confirmation and/or progression. He also mused about Chemo as well.. In the meantime he said to go to full dose 4 pills/day from my current very low dose of 3 pill per week.

Thanks

[Tall_Allen in reply to podsart]

From what I've read, AR-V7 is a fairly rare mutation at the start, but increases with hormone therapy use. There are many other causes of resistance. Since tests are expensive, it seems easier to just try the drug and see if it works.

[podsart in reply to Tall_Allen]

Understand; thank you

[podsart]

Thanks -- not sure how to research the "skepticism" of EPIC's test; however, I will try a google search [perhaps google scholar as well].

I will look into if Foundation One Medicine has a blood draw AR-V7 analysis.

Thanks