A future with too many tests and no comparative data about value?

The role of personalized genetic and genomic testing and the value of such testing to test to accurately and reliably predict things like the appropriateness of active surveillance as a management strategy or the risk for recurrence after first-line surgery is now evolving at almost bewildering speed. Furthermore, and sadly, even among the tests that have been developed and approved to date, there are almost no helpful data to clarify which test or tests might be the “best” (i.e., most accurate) to have under certain well-defined circumstances.

The rate of evolution is exemplified by the following two very recent papers:

The data from these two papers about new opportunities, along with all the other papers (that are now being published on an almost weekly basis) about genetic, genomic, and other markers, also have to be seen in the context of the tests that we already have both approved and available on the market (the Oncotype DX test, the Prolaris test, the ConfirmMDx test, etc., etc.).

It is shortly going to become imperative that we get a clear appreciation of the real, relative values of these tests in the accurate prognosis of defined types of prostate cancer. It is obviously good that we are being able to develop lost of different opportunities to better define individual prostate cancers, and assess how best to treat those cancers based on well characterized data. It is also going to become nightmare for clinicians and patients if we can’t know which tests are really the best one’s to use in very specific and well-defined circumstances. More may seem good for a while, but what one really wants as a patient or as a clinician is to know which test provides the highest level of informational input and value (without breaking the bank) in helping to determine what to actually do!

One Response

  1. I got pretty clear evidence from my UCSF urologist that the Oncotype test reliably placed me on active surveillance

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