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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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mspass | @mspass | Apr 22 10:03am
In reply to @sosophia245 "I would say Signatera test is a valuable tool. I was diagnosed with stage 2c high..." + (show)
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I would say Signatera test is a valuable tool. I was diagnosed with stage 2c high grade serous endometrial cancer with abnormal p53 in April 2025. Following surgery, I started chemo which I could not tolerate due to it causing severe neuropathy, heart issues, and high blood pressure. My oncologist hematologist recommended the test. I just had a low positive result after 2 negative test results and am scheduled for a PET scan.
I feel the tests are extremely important and can help guide treatment choices for patients like me that cannot tolerate chemo. They also can help determine if treatment is working. There are some oncologists that are not on board with the tumor-specific testing yet. They seem to be more concerned that there is not enough research behind it. However, there is new evidence coming out that validates the accuracy and value of this type of testing as it tailors treatment to the patient. Unfortunately, Cancer treatment “cookie-cutter” approaches (6 rounds of chemo, etc) for every patient needs to be revisited. Each one of us is different and our treatment plan should be focused on what works for each patient. My opinion, of course.

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@sosophia245

Agree.

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jmab | @jmab | Apr 22 11:37am
In reply to @peggydobbs "To lifetraveler: Many thanks for this information. I'm glad I changed Med Onco as well! BTW,..." + (show)
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To lifetraveler: Many thanks for this information. I'm glad I changed Med Onco as well! BTW, a different Med Onco told me that it's unclear if/how to change treatments plan based on results of Signatera. I think that's because circulating tumor DNA doesn't necessarily mean the existence of a solid tumor. Do you know anything more about this?

Also a question: are the blood tests for tumor markers covered by Medicare? So far, my Med Onco hasn't ordered any.
Many thanks in advance! Peg

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@peggydobbs it's definately confusing, all the different tests! I would only say, the most important thing is to find a qualified oncologist that you truly trust. It's fine to get opinions here, but we're not medical professionals. Some doctors refuse to order either the Signatera or the Oncotype test due to the fact that neither is 100% reliable.

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keepmoving2 | @keepmoving2 | Apr 28 11:57am

I have been taking the Signatera test for a number of years. It is but one test or tool in the toolbox that doctors and me use to assess either one of my 2 Stage 4 cancers. A single test and a single blood tumor test neither my doctors nor me rely on, get upset about, etc. We look for trends, rate of increase, and other confirming indicators.
Specifically, I did it for a removed ovarian brain tumor that was sent to Signatera in Feb 2024. I registered 0.47 - so not negative. But low. We watched it climb slowly to 7.88, and combined with my other tools of assessment, put a plan of action in place. But then it dropped to 7.0. Not doing anything special but retested and yes jumped to 10.51 in Dec 2025. Combined with PET, tumor markers, etc pivoted to weekly chemo in early Dec. My early March 2026 test showed my number dropping to 0.19. Now just a few more chemo treatments, PET looks better, CA125 way down. So my various tools once again confirmed each other. I meet with my oncology team next week but I suspect he won’t expect me to get to 0. Chemo will stop, we will keep me on some maintenance drugs, and I get to go back to monitoring and living my life. I understand my small “c” cancers are chronic conditions so tools for monitoring are very important to me, and their trends over time become equally important. Good luck!!

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kc5thyak | @kc5thyak | 15 hours ago
In reply to @einnoc "I, too, am interested in the Signaterra test for tracking any recurrence because I am one..." + (show)
Profile picture for einnoc @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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@einnoc
My oncologist at Root Causes in San Antonio told me that tumor samples are required to be kept for 10 years. I have had two CT Scans with contrast. Here in TX, the contrast is done via IV. They need to know if you have had a previous reaction to having contrast or if you have kidney disease. The only issue is you get a warm feeling that feels like you are wetting your pants, but in reality, you are not. It is just a feeling of it and it only lasts a minute, if that long. I have had no issue with the CT Scan with contrast.

I also had the Signatera test ordered by Root Causes. Took forever. The dr sent order in on May 28, 2026. Natera received the sample July 29, 2026. I got results on August 14, 2026. As far as I know, Medicare is paying for the test. My traditional oncologist with UT Health System has ordered a CARIS test, which I believe is similar to the Signatera test. I am anxious to get the results of the CARIS test, but it was ordered about the same time as the Signatera and still no results. My Signatera came back negative. I have uterine cancer Stage III2a and told it is a very rare, aggressive cancer. The CT Scan show some nodules in various locations, but they are too small to biopsy and it is not know if they are cancer or just nodules. I am doing chemo (Taxol and Carboplatin) and immunotherapy (Herceptin) since my tests showed my cancer was HER2+. I am also doing alternative treatment with Root Causes in San Antonio. My traditional oncologist told me before 1st chemo treatment that the don't see cancer in me, as it appears it was all removed through total hysterectomy on May 4. The chemo is just to get any microscopic cancer cells that may be floating around. I don't and didn't want to do chemo. If CARIS comes back negative, I probably will stop chemo, but continue the Herceptin immunotherapy. Prayers for all of you going through cancer treatment.

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katgob | @katgob | 9 hours ago

I had a Gardant Reveal which is similar to signatera. It took a month to get it back, and since i had a bone marrow transplant with a donor who was male. The Guardant people had been confused to my XY chromosomes as i checked female. Once my DRs office notified me they replied to them i had a transplant. My test came back negative. I also will need another one in 3-6 months. I only wanted it as my sister passed away May 31st and never wanted to take these tests. I told her i take most if not all i am offered.

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mspass | @mspass | 1 hour ago

I say take the tests....they are just a tool to help keep us alive. I have metastatic breast cancer, NED for 3 years, and take the Signatera test every three months. Best of luck to you on your journey.

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hsminc | @hsminc | 17 minutes ago

I have stage 1a triple negative. I have requested this Natera test from my new oncologist. After some serious disagreement and discussion he finally agreed it was probably the only tool we have to follow me. My kidney fxn is suboptimal and i have MGUS. Both these make it difficult if not impossible to safely have chemo.

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