EndoPredict newly covered; more predictive than OncotypeDX

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!