Signatera Test. Is it truly helpful and worthwhile?

Posted by pbnew @pbnew, Nov 30, 2023

I haven’t met anyone who has used this test. Do oncologists recommend it? How does it help?

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@einnoc

I, too, am interested in the Signaterra test for tracking any recurrence because I am one of the small % of people who absolutely cannot tolerate the A.I. drugs OR Tamoxifen (apparently). Therefore, my tumor, which is 95% estrogen positive and has an onco score of 29 is 36% likely to recur if I don't take adjuvant therapy drugs, and I really can't for the A.I. pills, for sure (crippled me for 6 months; very bad osteoarthritis and previously injured left knee joint. In the MOST study from 1997 to 2020). I have had 3 oncologists and none will order it, because there was no spread and the level of my tumor was 1A. I learned from talking to the company itself (twice) that you can pay for it yourself and it is affordable, whereas it is pricey if it is on insurance. Still, my best onco (Texas) is hesitant, so I have to have a CT Scan with contrast on Tuesday, because my LFT (Liver function Test) numbers are off the charts, whereas they were fine one year ago. My father had colon cancer which traveled to his liver and killed him within 6 months, so I am very nervous. I also have never had a CT scan wih contrast, which sounds not fun. I have the information from Signaterra about getting the test yourself, and what that would cost, if anyone wants me to copy it, but I think you still need a physician to authorize it and, so far, none of them will. I also wonder, "How long do they keep the tumor on ice to go in and examine those 14 strands?" I ask because mine was excised on 1/27/2022 and that is going on 2 years ago, so how many years do I have this option before the remaining tumor material is destroyed? 3? 5? Anybody know.

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I have been having the Signatera test done every six weeks. I read that Medicare will cover it at Stage 2B or higher and my UHC Medicare Advantage plan covered it. There are different Medicare Advantage plans from UHC. My oncologist agreed to order it. I have an ultra high risk recurrence score per my MammaPrint/BluePrint results. They used my core biopsy to set up the test. I had my core biopsy on August 27, 2023 and they sent some of the stored biopsy on Oct 11, 2023 for analysis when I had my first chemo infusion and I also hadvmy first blood draw that day. The first result took about 5 weeks because they had to analyze my biopsy to get markers. I have blood draws scheduled every 6 weeks. So far my results have been negative which means there is no Molecular Residual Disease which matches my tumor. Now my results come back in about a week. Signatera sends me the specialized blood vials. Their customer service is great. I had to have one of my blood draws in another state because I was in the middle of receiving Proton therapy there. Signatera will send a phlebotomist to do the draw. They came to me and it was no problem and no charge.
Natera blood biopsies have been used extensively to monitor colon cancer but using them for breast cancer is a fairly new development. According to studies that I have seen, the ctDNA is predictive much sooner than radiologic imaging. That extra time might give you a window to adjust treatments if you have a positive test result.

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@einnoc

I, too, am interested in the Signaterra test for tracking any recurrence because I am one of the small % of people who absolutely cannot tolerate the A.I. drugs OR Tamoxifen (apparently). Therefore, my tumor, which is 95% estrogen positive and has an onco score of 29 is 36% likely to recur if I don't take adjuvant therapy drugs, and I really can't for the A.I. pills, for sure (crippled me for 6 months; very bad osteoarthritis and previously injured left knee joint. In the MOST study from 1997 to 2020). I have had 3 oncologists and none will order it, because there was no spread and the level of my tumor was 1A. I learned from talking to the company itself (twice) that you can pay for it yourself and it is affordable, whereas it is pricey if it is on insurance. Still, my best onco (Texas) is hesitant, so I have to have a CT Scan with contrast on Tuesday, because my LFT (Liver function Test) numbers are off the charts, whereas they were fine one year ago. My father had colon cancer which traveled to his liver and killed him within 6 months, so I am very nervous. I also have never had a CT scan wih contrast, which sounds not fun. I have the information from Signaterra about getting the test yourself, and what that would cost, if anyone wants me to copy it, but I think you still need a physician to authorize it and, so far, none of them will. I also wonder, "How long do they keep the tumor on ice to go in and examine those 14 strands?" I ask because mine was excised on 1/27/2022 and that is going on 2 years ago, so how many years do I have this option before the remaining tumor material is destroyed? 3? 5? Anybody know.

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Check with Natera about timing on tumor tissue analysis and physician scripting. They may have resources.

I think tissue banking for years is fairly standard. I’m sure there must be some limit. Check with the lab ( hospital) that stores your tissue.

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@mamabea

I still don't understand the purpose of the test. I understand it will tell if any cancer cells are running around, but if we don't know where, what is the difference? It would seem to be very upsetting to wait for the cancer to become more apparent. We could have just waited.

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As a caregiver I listen to what the oncologist explain about the test and its significance. What I understand is that the split DNA cancer cells in the blood stream may lodge in any other organs and tumor develop at anther site. Then it would a total different way to deal with the new tumor. Surgery, chemo and radiation etc. So it is better to keep this Signatera result at 0.00 with the maintenance treatment. I hope this gives you some clarification.

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My husband is getting help with signatera tests after his colon cancer surgery. After 12 chemo (twice a month) the signatera 6 results showed 0.00. But 7, 8 and 9th result showed upward graph with slow increase in number of split DNA Cancer cells in the blood stream so no again he is given that chemo treatment twice a month. The current result showed decrease in number which confirms the chemo treatment is working to keep the split DNA cancer cells in control. My worry is that at what time this chemo will be stopped? Because constant bombarding one's body with chemo drugs will leave the patient weaker and weaker along the way. I hope I can find an answer to that. Wishing full recovery and no further treatment needed for my husband. With what we have been gone through Signatera test is useful.

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what range if cost is it? so is it important to get a level before surgery even before staging has been determined? Surgery in 3 wks for hepatic flexure lesion.

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@danandnan2024

what range if cost is it? so is it important to get a level before surgery even before staging has been determined? Surgery in 3 wks for hepatic flexure lesion.

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My understanding is that you need a sample of the original biopsy. then all Signatera tests are compared with it. I’ve heard that Medicare covers it but it’s free if the patient doesn’t have Medicare. In Europe the test is 4000 euros each time. It seems to be a test that has to be done regularly for a long time. I haven’t had a test yet because I’m told an oncologist has to order it. I live in Texas but get my treatment in Europe. I don’t have an oncologist in Texas. I contacted an oncology office but was rejected because I’m not a patient. All I’m asking for is a prescription for a non invasive test.

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