Exo mdx logo Physicians KO

The only exosome-based test that provides unique, actionable intelligence to help you decide if biopsy is necessary; independent of PSA and other standard of care (SOC) features.

What is the Exo mdx test?

Exo mdx is a simple, non-DRE, urine-based, liquid biopsy test indicated for men 50 years of age and older with a prostate-specific antigen (PSA) 2-10ng/mL, or PSA in the “gray zone”, considering prostate biopsy. Exo mdx returns a risk score that determines a patient’s risk of clinically significant prostate cancer (≥GG2 (GS 3+4)) on prostate biopsy. A score above the validated cut-point of 15.6 is associated with an increased likelihood of ≥GG2 (GS 3+4) on a biopsy and a score below the cut-point of 15.6 is associated with a decreased likelihood of ≥GG2 (GS 3+4). This test can help reassure a patient to avoid a prostate biopsy or improve patient compliance with physician recommendation.

What’s unique about the Exo mdx test is that it is an exosome-based genomic test that offers an additional data point that is not obtained through the general work up. It offers unique intelligence that is not influenced by DRE, family history, PSA, or other standard of care features.

Key Features of the Exo mdx Test

91%

Negative Predictive Value for Exo mdx

92%

Sensitivity for Exo mdx

92%

Improved Patient Compliance to Physician Recommendation

30%

More HGPCa Identified vs. SOC Alone

Clinical Validity

The clinical validity of Exo mdx is supported by multiple peer-reviewed publications and presentations, representing approximately 5000 patients from 40 academic and community urology clinics in the US.

The Exo mdx test has been clinically validated to risk stratify clinically significant prostate cancer from low grade prostate cancer and benign disease. A patient-specific individual risk score is calculated based on a proprietary algorithm that combines the weighted expression of a three-gene signature associated with clinically significant prostate cancer (PCA3, SPDEF, ERG) directly from urinary exosomal RNA.

Negative

Positive

Ordering & Coverage: Medicare and Private Insurance Options


Ordering is simple with options for both in-office and at-home collection. Insurance coverage and telehealth compatibility make it accessible for diverse patient needs.

Numerous Studies Verify Exo mdx’s Clinical Utility and Validity

McKiernan J, Donovan MJ, O’Neill V, et al. A Novel Urine Exosome Gene Expression Assay to Predict High-grade Prostate Cancer at Initial Biopsy. JAMA Oncology. 2016;2(7):882. https://doi.org/10.1001/jamaoncol.2016.0097

Margolis E, Brown GE, Partin AW, et al. Predicting high-grade prostate cancer at initial biopsy: clinical performance of the ExoDx (EPI) Prostate Intelliscore test in three independent prospective studies. Prostate Cancer and Prostatic Diseases. 2021;25(2):296-301. Doi:https://doi.org/10.1038/s41391-021-00456-8

Tutrone R, Donovan MJ, Torkler P, et al. Clinical utility of the exosome based ExoDx Prostate(IntelliScore) EPI test in men presenting for initial Biopsy with a PSA 2–10 ng/mL. Prostate Cancer and Prostatic Diseases. 2020;23(4):607-614. Doi:https://doi.org/10.1038/s41391-020-0237-z

Tutrone R, Lowentritt B, Neuman B, et al. ExoDx prostate test as a predictor of outcomes of high-grade prostate cancer – an interim analysis. Prostate Cancer and Prostatic Diseases. 2023;26(3):596-601. Doi:https://doi.org/10.1038/s41391-023-00675-1

Publications & Abstracts

  1. Moul J, Punnen S, Pavlovich C, et al. MP19-10 EVALUATING EXODX PROSTATE TEST IN MEN WITH LOW-GRADE PROSTATE CANCER ON ACTIVE SURVEILLANCE–A MULTI-CENTER PROSPECTIVE TRIAL. Journal of Urology. 2025;213(5S).
  2. Tutrone R, Lowentritt B, Neuman B, et al. Correction to: ExoDx prostate test as a predictor of outcomes of high-grade prostate cancer – an interim analysis. Prostate Cancer and Prostatic Diseases. 2023;27(1):161-161.
  3. Tutrone R, Lowentritt B, Neuman B, et al. Correction to: ExoDx prostate test as a predictor of outcomes of high-grade prostate cancer – an interim analysis. Prostate Cancer and Prostatic Diseases. 2023;27(1):161-161.
  4. Kretschmer A, Tutrone R, Alter J, et al. Pre-diagnosis urine exosomal RNA (ExoDx EPI score) is associated with post-prostatectomy pathology outcome. World Journal of Urology. 2022;40(4):983-989.
  5. Yu W, Hurley J, Roberts D, Chakrabortty D, Enderle M, Noerholm X.O., Breakfield & Skog J. K.m: Exosome microRNAs as liquid biopsies for the monitoring of prostate cancer. Research Outreach. 2021;(127).
  6. Motamedinia P, Scott AN, Bate KL, et al. Urine Exosomes for Non-Invasive Assessment of Gene Expression and Mutations of Prostate Cancer. Kyprianou N, ed. PLOS ONE. 2016;11(5):e0154507.
  7. Kretschmer A, Kajau H, Margolis E, et al. Validation of a CE-IVD, urine exosomal RNA expression assay for risk assessment of prostate cancer prior to biopsy. Scientific Reports. 2022;12(1).
  8. Nilsson J, Skog J, Nordstrand A, et al. Prostate cancer-derived urine exosomes: a novel approach to biomarkers for prostate cancer. British Journal of Cancer. 2009;100(10):1603-1607.
  9. Chakrabortty SK, Khodor YL, Kitchen R, et al. Exosome based analysis for Space Associated Neuro-Ocular Syndrome and health risks in space exploration. NPJ microgravity. 2022;8(1).
  10. Zanello SB, Tadigotla V, Hurley J, et al. Inflammatory gene expression signatures in idiopathic intracranial hypertension: possible implications in microgravity-induced ICP elevation. npj Microgravity. 2018;4(1).
  11. Albala DM. The Role of ExoDx Prostate Test in Early Detection of Prostate Cancer. Urology Times. 2021.
  12. Moul J, Sant G. How I Use It; The Exosome Diagnostics (EPI) prostate cancer biomaker utility in urology and primary care. 2022(4):11224-11230
  13. Donovan MJ, Noerholm M, Bentink S, et al. A molecular signature of PCA3 and ERG exosomal RNA from non-DRE urine is predictive of initial prostate biopsy result. Prostate Cancer and Prostatic Diseases. 2015;18(4):370-375.
  14. Alter J, Albala DM. Integrating biomarkers and multi-parametric MRI to provide enhanced clinical diagnosis for prostate cancer. Frontiers in Urology. 2023;3.
  15. Margolis E, Brown GE, Partin AW, et al. Predicting high-grade prostate cancer at initial biopsy: clinical performance of the ExoDx (EPI) Prostate Intelliscore test in three independent prospective studies. Prostate Cancer and Prostatic Diseases. 2021;25(2):296-301.
  16. McKiernan J, Noerholm M, Tadigotla V, et al. A urine-based Exosomal gene expression test stratifies risk of high-grade prostate Cancer in men with prior negative prostate biopsy undergoing repeat biopsy. BMC Urology. 2020;20(1).
  17. Tutrone R, Donovan MJ, Torkler P, et al. Clinical utility of the exosome based ExoDx Prostate(IntelliScore) EPI test in men presenting for initial Biopsy with a PSA 2–10 ng/mL. Prostate Cancer and Prostatic Diseases. 2020;23(4):607-614.
  18. McKiernan J, Donovan MJ, Margolis E, et al. A Prospective Adaptive Utility Trial to Validate Performance of a Novel Urine Exosome Gene Expression Assay to Predict High-grade Prostate Cancer in Patients with Prostate-specific Antigen 2–10 ng/ml at Initial Biopsy. European Urology. 2018;74(6):731-738.
  19. McKiernan J, Donovan MJ, O’Neill V, et al. A Novel Urine Exosome Gene Expression Assay to Predict High-grade Prostate Cancer at Initial Biopsy. JAMA Oncology. 2016;2(7):882.
  20. Brinkman K, Meyer L, Bickel A, et al. Extracellular vesicles from plasma have higher tumour RNA fraction than platelets. Journal of Extracellular Vesicles. 2020;9(1):1741176.
  21. Skog J, Würdinger T, van Rijn S, et al. Glioblastoma microvesicles transport RNA and proteins that promote tumour growth and provide diagnostic biomarkers. Nature Cell Biology. 2008;10(12):1470-1476.
  22. Möhrmann L, Huang HJ, Hong DS, et al. Liquid Biopsies Using Plasma Exosomal Nucleic Acids and Plasma Cell-Free DNA Compared with Clinical Outcomes of Patients with Advanced Cancers. Clinical Cancer Research. 2018;24(1):181-188.
  23. Brock G, Castellanos-Rizaldos E, Hu L, Coticchia C, Skog J. Liquid biopsy for cancer screening, patient stratification and monitoring. Translational cancer research. 2018;4(3):280-290.
  24. Miranda KC, Bond DT, McKee M, et al. Nucleic acids within urinary exosomes/microvesicles are potential biomarkers for renal disease. Kidney International. 2010;78(2):191-199.
  25. Alter J, Kumar S, Skog J, Verma V, Yao Y, Ray CJ, Haynes B, Belkoff L, Tutrone R, Cahn DJ, Dato P, Hafron J, Taylor Z, Serpico S, Huynh L, Ayre ET, Biesecker CE, Golshan K. Exosome biomarker clinical impact on timing and decision to have a prostate biopsy. Presented at: American Urological Association Annual Meeting (AUA); 2024; abstract MP41-04.
  26. Tutrone R, Kumar S, Ray C, Alter J, Sant G, Yao Y, Verma V, Skog J. Utilization of ExoDx prostate test for prostate cancer risk stratification in the African American population. Presented at: American Urological Association Annual Meeting; 2024.
  27. Chakrabortty SK, Kitchen RR, Coticchia CM, et al. Abstract LB-226: Exosomal liquid biopsy reveals mRNA and lincRNA biomarkers in early stage breast cancer patient plasma. Cancer Research. 2018;78(13_Supplement):LB-226-LB-226.
  28. Hurley J, O’Neill V, Brock G, et al. Abstract 4969: Exosomal RNA based liquid biopsy detection of androgen receptor variant 7 in plasma from prostate cancer patients. Cancer Research. 2016;76(14_Supplement):4969-4969.
  29. Hurley J, Bentink S, Hu L, Srivastava A, Karecci E, Mihali A, Gauvin D, Brock G, Azzi J, Skog J. Discovery and validation of a urinary exosomes mRNA signature for the diagnosis of human kidney transplant rejection. Presented at: scientific poster presentation; 2016. Poster 443.
  30. Kasraeian A, Albala D, Sant G, Moul J, Hurley L, Punnen S, Alter J, Tutrone R. Development and utility of an at home urine (EPI) test kit during COVID-19 pandemic to support prostate cancer diagnosis, shared-decision making and telehealth. Presented at: American Urological Association Northeastern Section Meeting; October 27-29, 2022; Charlotte, NC.
  31. Meyer L, Enderle D, Lück C, Bickel A, Khan Y, Heger C, Schlumpberger M, Sprenger-Haussels M, Skog J, Noerholm M. Detection of MISEV recommended EV protein-markers using automated western blotting. Presented at: scientific poster presentation; 2020.
  32. Chakrabortty SK, Khodor YL, Lang SP, Rauscher M, Tadigotla V, Kitchen RR, Singh M, Hoffman A, Papas A, Yu S, Skog J. Identification of a saliva exosomal RNA signature for Sjögren’s syndrome. Presented at: International Society for Extracellular Vesicles (ISEV) Annual Meeting; July 20-22, 2020; virtual meeting. Poster 829779.
  33. Khodor YL, Chakrabortty SK, Rauscher M, Fischer CA, Lang SP, Small J, Balaj L, Carter B, Yu S, Skog J. Identification of plasma-derived, EV-based biomarkers for glioblastoma. Presented at: International Society for Extracellular Vesicles (ISEV) Annual Meeting; July 20, 2020; virtual meeting. Presentation 830008.
  34. McKiernan JM, Tutrone RF, Donovan MJ, et al. Urine exosome gene expression assay net benefit analysis in a large pooled cohort. Journal of Clinical Oncology. 2020;38(6_suppl):287-287.
  35. Calle* C de la, Fasulo V, Cowan J, et al. PD53-02 CLINICAL UTILITY OF BIOMARKERS 4K SCORE, SELECTMDX AND EXODX WITH MRI FOR THE DETECTION OF HIGH-GRADE PROSTATE CANCER. The Journal of Urology. 2020;203:e1096.
  36. McKiernan J, Donovan M, Margolis E, et al. MP40-10 EXTENDED VALIDATION RESULTS FROM A PROSPECTIVE ADAPTIVE UTILITY TRIAL CONFIRM PERFORMANCE OF A NOVEL URINE EXOSOME GENE EXPRESSION ASSAY TO PREDICT HIGH-GRADE PROSTATE CANCER AT INITIAL BIOPSY. Journal of Urology. 2018;199(4S).
  37. Donovan MJ, Torkler P, Noerholm M, Skog J, McKiernan JM. Performance of a clinically validated urine exosome gene expression test to predict high grade prostate cancer in men with a prior negative biopsy. Journal of Clinical Oncology. 2018;36(6_suppl):119-119.
  38. McKiernan J, Donovan M, Margolis E, et al. MP46-05 DEVELOPMENT OF A CLINICAL IMPLEMENTATION PLAN (CAREPATH) FOR A NOVEL URINE EXOSOME GENE EXPRESSION ASSAY AS PART OF A TWO-COHORT, ADAPTIVE DECISION IMPACT UTILITY TRIAL. Journal of Urology.
  39. Chakrabortty SK, Kitchen RR, Coticchia CM, et al. Abstract LB-226: Exosomal liquid biopsy reveals mRNA and lincRNA biomarkers in early stage breast cancer patient plasma. Cancer Research. 2018;78(13_Supplement):LB-226-LB-226.
  40. Donovan M, Phillipp Torkler, Mikkel Noerholm, Skog J, McKiernan J. MP33-05 RADICAL PROSTATECTOMY OUTCOMES FROM A VALIDATED URINE EXOSOME GENE EXPRESSION ASSAY WHICH PREDICTS HIGH-GRADE (GS7) PROSTATE CANCER SUGGESTS UTILITY FOR MEN ENROLLED IN ACTIVE SURVEILLANCE. The Journal of Urology. 2017;197(4S).
  41. Donovan M, Torkler P, Skog J, Noerholm M, Carroll P. Performance of a validated urine exosome gene expression assay to predict high-grade prostate cancer utilizing the International Society of Urological Pathology (ISUP) 2014 grading system. Journal of Clinical Oncology. 2017;35(6_suppl):49-49.
  42. Donovan M, Torkler P, Skog J, Noerholm M, Carroll P. Performance of a validated urine exosome gene expression assay to predict high-grade prostate cancer utilizing the International Society of Urological Pathology (ISUP) 2014 grading system. Journal of Clinical Oncology. 2017;35(6_suppl):49-49.