My PT3AN1M0 was treated with RC and then four cycles of DD-MVAC. My Signatera so far has been negative (2024-12-04, 2025-01-21, 2025-03-05). My Mayo oncologist has added Northstar Response (first draw 2025-03-06) at my request and it came back at 31 (just above the 25 bottom range). I am waiting on his next step: perhaps nivolumab immunotherapy. Or perhaps wait for a re-test in 2025-04. A successive Northstar Response test may come back negative in case the fourth DD-MVAC cycle (2025-03-06) was effective or earlier DD-MVAC cycles were already effective and the ctdna detected was necrosis dna. My 2025-02 CT/MRIs were clean. My next set of CT/MRIs are in 2025-05. But perhaps these will be moved up.

I am the first urology oncology Northstar Response patient at Mayo Jacksonville, FL. My oncologist is unfamiliar with this agnostic ctdna test and noted that there is very limited data on it. Northstar Response is 10X more sensitive than Signatera apparently. My oncologist has repeatedly told me that signatera informs his treatment decisions. Perhaps Northstar Response will also assist in his treatment assessment.

This patient has a blog where I learned about Northstar Response. https://www.treffertinnovations.com/blog.html

My oncologist told me this week he may skip nivolumab to ensure ev/keytruda is an option. If opdivo fails that may exclude future use of keytruda. So it is a challenging decision.