ASCO 2013 Video: Can we predict response to Tarceva based on a blood test? - 1257204

Dear JimC and Grace Staff,

We know that insurance companies have a reputation for not playing fair, but I want you to know that I have just had a phone contact with a rep from Biodesix, who makes the Versitrat Test. He told me that BlueCrossBlueShield of Texas denies coverage of Veristrat, calling the test "obscure". We do not have to bother Drs. West, Pennell or Pinder on this matter unless they are wanting to chime in - as this is just shamefully ignorant or dripping with fanatical denial of powerful information. How can these people making and enforcing these answers go home and digest their dinner with a clear conscience?

Texandave

Stage IV lung adenocarcinoma diagnosed in nonsmoker who worked in labs with ethydium bromide, benzene and toluene which were questionably vented for a couple of years. No family history of lung cancer. Thankfully NED for several months; been on Tarceva since March 2012. Ready to create patient/caregiver EGFR+ thread.

Texandave,

I don't mean to be an apologist or defender of any insurer, but I think that the Biodesix test doesn't really answer a question I consider to be that helpful. It essentially asks "should I not even bother with an EGFR tyrosine kinase inhibitor like Tarceva?" It doesn't say that doing Tarceva (erlotinib) is a better idea than chemo, and it essentially can only say it's a worse idea than second line chemo in some patients. There's now a growing amount of evidence to say that it's arguably best to give chemo over Tarceva as second line therapy to anyone who doesn't have an activating EGFR mutation, so if you follow that strategy, the only clear value of the Veristrat test is to say whether Tarceva isn't even worth trying later. If you're going to decide to not even take Tarceva if the Veristrat test comes back as poor, I think the test makes sense. But most of my patients aren't eager to eliminate an FDA approved option that might help and will almost always be covered as a third line agent for NSCLC, so I don't see how Veristrat provides an actionable answer to any question I'd commonly ask in my clinic patients.

-Dr. West