Molecular and genomic testing for prostate cancer

Urology Austin offers additional molecular and genomic testing for our patients. The inclusion of molecular testing gives additional independent information, so that the patient and their doctor can confidently choose an individualized treatment plan that is appropriate.

There are several molecular and genomic tests available for different stages of treatment that include pre-biopsy, positive prostate biopsy, post-surgery (prostatectomy) and during treatment of advanced prostate cancer. Ordering a specific test depends on different factors including the patient’s specific clinical presentation, history and the volume and quality of the tumor tissue remaining after a biopsy.

Billing and out-of-pocket costs

All billing for molecular testing will come from the manufacturer of each test, not from Urology Austin.  Remember, an Explanation of Benefits (EOB) is not a bill.  If you have any questions regarding a bill or EOB please call the appropriate test manufacture listed below.  In rare cases, there may not be enough tumor tissue remaining after diagnosis to run a molecular test.  In that case you will not be billed.

Patients are typically covered by insurance for molecular testing.  However, patients should check with their individual insurance carrier to confirm their benefits prior to testing. The manufacturer of each test can also be contacted to discuss specific coverage questions.

Available Molecular and Genomic Tests

The following is a brief outline of the available molecular and genomic tests your physician may order. We recommend that you learn more about these tests by visiting their company websites.

Prolaris: a genomic test developed and marketed by Myriad Genetics, Inc. This test is indicated for patients who have been diagnosed with low to intermediate or high-risk prostate cancer. This risk assessment tool can help predict how aggressive the tumor may be or become in the future. This information guides the physician and patient with treatment decisions.  The report provides information on pursuing active surveillance or if specific therapies like radiation or ADT are necessary.  Click here to learn more about Prolaris.

Oncotype Dx: a genomic test developed and marketed by Genomic Health. Similar to other risk stratification tests, Oncotype is indicated for newly diagnosed patients with low to intermediate risk prostate cancer. Predicting the aggressiveness of the tumor can help a physician and patient decide the appropriate course of treatment. Click here to learn more about Oncotype Dx.

Oncotype Dx AR-V7 Nucleus Detect: This blood test is specifically designed for metastatic castrate-resistant prostate cancer and can test for the AR-V7 protein, which is a predictive biomarker. The results of the test allow the physician and patient to decide if switching to another oral oncolytic is appropriate or to proceed with chemotherapy. Click here to learn more about Oncotype Dx AR-V7 Nucleus Detect.

Decipher: a genomic test developed and marketed by Genome Dx. This test has two variants 1) Decipher Prostate Biopsy and 2) Decipher Prostate RP. Decipher Prostate Biopsy is used in low to intermediate risk prostate cancer, it reports on genomic markers associated with high risk disease. The information gathered in this report can allow the physician and patient to make decisions regarding primary treatment for prostate cancer. Deciper Prostate RP is indicated for use after the prostate gland has been removed via surgery (prostatectomy). The tissue is analyzed and predicts the probability of developing metastatic disease within 5 years after surgery. The information provided by this test can assist the physician and patient to decide if additional treatment, such as external radiation is appropriate. Click here to learn more about Decipher.

Confirm MDx: This molecular test is developed and marketed by MDxHealth. This test is indicated for men who have undergone a prostate biopsy and the pathology resulted in a atypical or negative result. The physician can decide to order this test when a patient presents with high risk factors for prostate cancer such as, a very high PSA or nodule, but shows negative or atypical pathology after biopsy. The basic principle of this test is to prove a negative. It can contribute to the follow up protocol and when positive, could indicate a repeat prostate biopsy to the positive areas. Click here to learn more about Confirm MDx.

Select MDx: A genomic test offered by MDxHealth. This test is indicated for men with an elevated PSA and therefore at a higher risk for prostate cancer. The urine is tested for 2 genes associated with aggressive prostate cancer and can help predict the chance of finding high grade prostate cancer and/or any grade of prostate cancer at biopsy. The result of this test can help the patient and physician decide to proceed or postpone a prostate biopsy. Click here to learn more about Select MDx.

If you have been diagnosed with prostate cancer and would like to learn more about molecular testing, contact your Urology Austin provider.