BlueCross BlueShield of Tennessee Medical Policy Manual

In Vitro Chemosensitivity and Chemoresistance Assays


In vitro chemoresistance and chemosensitivity assays have been proposed as a means to provide information about the characteristics of an individual’s malignancy; such as predicting responsiveness of their cancer to specific drugs.

Although a variety of assays exist to examine chemosensitivity or chemoresistance, most are laboratory developed tests and a few are commercially available (e.g. Oncotech Extreme Drug Resistance (EDR) assay, ChemoFX® assay, BluePrint® 80-Gene Subtyping Assay). All the assays involve the same four basic steps:




The evidence is insufficient to determine the effects of the technology on health outcomes. The use of chemotherapy sensitivity and resistance assays to select chemotherapeutic agents for individuals is not recommended outside of the clinical trial setting.


American Society of Clinical Oncology. (2011). Clinical practice guideline update on the use of chemotherapy sensitivity and resistance assays. Journal of Clinical Oncology, 29 (24), 3328-3330.

American Society of Clinical Oncology. (October, 2014). Chemotherapy and targeted therapy for women with human epidermal growth factor receptor 2-negative (or unknown) advanced breast cancer: American Society of Clinical Oncology clinical practice guideline. Retrieved March 18, 2016 from the National Guideline Clearinghouse (NGC: 10558).

BlueCross BlueShield Association. Medical Policy Reference Manual. (9:2017). In vitro chemoresistance and chemosensitivity assays (2.03.01). Retrieved February 15, 2018 from BlueWeb. (57 articles and/or guidelines reviewed)

Jenks, S. (2012). Chemosensitivity assays: still eyeing the clinic. Journal of the National Cancer Institute, 104 (23), 1775-1777. (Level 5 evidence)

Kim, J., Kim, S., Cho, D., Ha, Y., Choi, E., Kim, C., et al. (2011). Novel chemosensitive single-nucleotide polymorphism markers to targeted regimens in metastatic colorectal cancer. Clinical Cancer Research. 17 (5); 1200-1209. (Level 3 evidence)

Kim, J., Lee, K., Kim, Y., Lee, K., Oh, D., Kim, J., et al. (2010). Individualized tumor response testing for prediction of response to Paclitaxel and Cisplatin chemotherapy in patients with advanced gastric cancer. Journal of Korean Medical Science, 25 (5), 684-690. (Level 4 evidence - Independent study)

Li, S., Zeng, A., Hu, Q., Yan, W., Liu, Y., & You, Y. (2017). MiR-423-5p contributes to a malignant phenotype and temozolomide chemoresistance in glioblastomas. Neuro Oncology, 19 (1), 55-65. Abstract retrieved February 16, 2017 from PubMed database.

National Comprehensive Cancer Network (2018, February) NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Ovarian cancer including fallopian tube cancer and primary peritoneal cancer. Retrieved February 15, 2018 from

Winifred S. Hayes, Inc. Genetic Technology Evaluation (GTE) Report (2014, December). BluePrint molecular subtyping profile for breast cancer. Retrieved December 14, 2015 from (45 articles and/or guidelines reviewed)

Wisconsin Physician Services Corporation. (2017, December). Local Coverage Determination (LCD): Special histochemical stains and immunohistochemical stains (L36805). Retrieved February 15, 2018 from




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