The AR-V7 blood test may help patients and doctors make decisions on treatment choices when prostate cancer patients are metastatic, and castrate resistant, or mCRPC. The term AR-V7 stands for androgen-receptor splice variant 7. This blood test recently became available to the public through Johns Hopkins’ Molecular Diagnostics Lab.
No blood test is perfect, but having a negative AR-V7 test has shown the following in a study of 62 men, published in New England Journal of Medicine Sept 2014:
- Better PSA response to Zytiga (abiraterone) and/or Xtandi (enzalutamide)
- Better progression-free survival and overall survival when taking Zytiga (abiraterone) and/or Xtandi
In another small study (37 men) published in JAMA Oncology June 2015, having a positive AR-V7 test did not hinder men from responding to chemotherapy, specifically Taxotere (docetexel) and/or Jevtana (cabazitaxel). In addition, it was noted that “certain patients with detectable AR-V7 at baseline converted to AR-V7 negative status during the course of taxane therapy [chemo].” There are no promises that a man’s AR-V7 test can be improved (from positive to negative) after doing Taxotere or Jevtana, but at a dinner presentation at ASCO 2016, Dr Antonarakis stated that so far, they have seen this in “about 50% of patients.”
Dr Dan Petrylak also discusses AR-V7 in this short (2016) video.
*IMPORTANT – The AR-V7 blood test may or may not be covered by your insurance. If it is NOT covered by insurance, the cost is approximately $1,000 right now. It is advised that you call your insurance company and ask about insurance coverage. It is essential to give your doctor the right CPT code to write on the order – See Step 7 below.
As a patient or caregiver, you will need to do the following to obtain an AR-V7 test:
- Verify that your prostate cancer is “metastatic, castrate-resistant.”
- Print this requisition form from Johns Hopkins lab, and show to your doctor. Ask your doctor if he will write the order/script for the test. (The doctor who writes the script for the AR-V7 test CANNOT be in FL or NY.)
- Find a local lab who is willing to draw the blood for you, according to detailed instructions on AR-V7 requisition form. (tip – Medical oncologists usually have their own lab for blood draw, in their clinic.)
- There are special FedEx refrigerated shipping instructions you have to follow. The FedEx package must also arrive at Johns Hopkins lab before 10:00 am the next day (not in the afternoon). If the lab who draws your blood cannot do this shipping procedure, you may have to do it and pay for it yourself. For further questions on this shipping to JH lab, you can contact them at firstname.lastname@example.org or (410) 955-1438. Hours are 8:30 am – 5:30 pm EST, M-F.
- Since the blood needs to be received by Johns Hopkins the next morning, you cannot draw your blood at your local lab on a Friday. Make sure your AR-V7 blood test is drawn Mon – Thu.
- The turnaround time can vary, but test results are usually released to your doctor in 1 – 2 weeks. Ask for your own copy.
- For information on the ordering code (CPT code), call the JH lab at (410) 955-1438.
*For more information on this article, call Jan Manarite of PAACT at her home office – (239) 208-4400, or email her at JManarite@paact.help