EndoPredict newly covered; more predictive than OncotypeDX

ChiSandy

Anthem now covers EndoPredict, possibly more accurate than OncotypeDX

Anthem (BCBS) is the latest insurer to approve coverage for Myriad Genetics' EndoPredict second-generation genomic test, which suggests high or low recurrence risk at 5 and 10 years for early stage breast cancer patients. It outperformed first-generation OncotypeDX in this regard—it has indicated more node-positive patients were at low risk than their OncotypeDX scores predicted, borne out by preliminary real-world DFS survival statistics. EndoPredict's accuracy was higher than OncotypeDX's at both the 5-through-10-year mark for all tested patients as well. OncotypeDX was not accurately predictive for years 5 through 10. EndoPredict's “likelihood risk" at 0-5 and 0-10 years for node-negative patients was almost double that of OncotypeDX's, and five times as accurate for node-positive patients. More patients were able to safely skip chemo based on their EndoPredict score as “low-risk" than were patients scoring low (and presumably lower intermediate*) risk on OncotypeDX.

Note that both tests are only for ER+/HER2- patients; the article did not mention PR+ (Luminal A) vs. PR- (Luminal ; the latter's OncotypeDX scores are usually higher than the former; grade 2 v. grade 3 was also not mentioned—but sometimes there was no correlation between grade and low vs. intermediate and intermediate vs. high OncotypeDX scores.

I might see if BCBS will cover it for me despite being nearly 2 years post-dx & surgery, 21 mos. post-rads and 18 mos. into AI therapy, in case my “higher-low" ODX score of 16 puts me at higher or lower mets risk w/o chemo than GenomicHealth, my MO & I believed (and the online calculators suggest). Not that I want chemo, but if it turns out to be advisable…; and if confirmed inadvisable, makes me more confident about having skipped it.

*BarredOwl, do you have more info and better access to the actual study, and did it mention the specific OncotypeDX scores? Please let us know!

muska

There are more details on EndoPredict on the Myriad Website. It doesn't look stage III like myself could use it. The test is for ER+, HER2− early-stage breast cancer patients (N0 or N+, up to 3 nodes, pre- or postmenopausal)

KathyL624

This makes me nervous. I had a low oncotype score and scared it wasn't accurate! What if Endopredict would have gotten me chemo