We have recently learned that Medicare will be covering the costs of the Oncotype DX AR-V7 Nucleus Detect™ test for patients with metastatic, castration-resistant prostate cancer (mCRPC) as of December 10, 2018.
The full media release and related information about the test itself are available on the Genomic Health corporate web site.
Basically, this is a test designed to assist you and your doctor to know whether you may have a specific genetic mutation known as AR-V7 that is associated with whether — if you have mCROPC — you are or are not a good candidate for treatment with drugs like enzalutamide and abiraterone acetate. If you are not a good candidate for treatment with one of these drugs, you may be wiser to get treatment with taxane-based chemotherapy.
Filed under: Living with Prostate Cancer, Management, Treatment | Tagged: AR-V7, Genomic Health, Oncotype, test |
THE "NEW" PROSTATE CANCER INFOLINK 
“If you are not a good candidate for treatment with one of these drugs, you may be wiser to get treatment with taxane-based chemotherapy.”
…. or second-line antiandrogens not restrained by an AR V7 mutation. Apalutamide (Erleada) claims it works in the presence of AR V7.
Dear Rick:
Erleada is not approved for the treatment of metastatic CRPC. It is only approved for the treatment of non-metastatic CRPC, so neither Medicare nor insurance providers will cover its use in metastatic CRPC as yet (as far as I am aware).
Dr. William Oh at Mount Sinai, NYC is prescribing Erleada to metastatic CRPC Medicare patients. … I cannot tell you how, but it should be considered a second line antiandrogen that is accessible if a man is AR V7 positive.
BTW, what is the ‘O’ for in mCROPC?
Dear Rick:
Things that are available at major academic medical centers may be available for all sorts of reasons, and patients may not know exactly how or why.
The 0 in mCR0PC is a typo. These things happen.