Signatera results increase from .53 to 1.97

Posted by gpit @gpit, 2 days ago

New to forum... 8 months post op Ivor Lewis Esophagectomy adenocarcinoma at esophagus / stomach junction 5 rounds of folfox5 before surgery and 4 rounds after, last chemo first week of December 2025. PET and CT scan in February 2026 shows no evidence of disease. Signatera lab from January 2026 reported .53 MTM/mL and follow up April 2026 reported 1.97 MTM/mL. I have an appointment already scheduled with oncology next week, just looking for thoughts/experience with this kind of resultfrom a signatera lab and should I be overly concerned at this point or wait for 1 more test to get a definitive trend before I pull the trigger on a treatment plan. I eat extremely no/low carb and my career as an industrial electrician keeps me averaging around 16k steps a day 4 to 5 days a week.
looking forward to any input... thanks

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mrgvw | @mrgvw | 1 day ago

Signatera data is exactly why you're being monitored with this additional tool. Is it 100% definitive for recurrence... not for me to say. But ctDNA monitoring is supposed to show much earlier detection that your cancer could be on the move again... months before it takes hold somewhere and becomes large enough to show up on any scans. Your oncologist will be paying more attention now... possibly moving up scans, or adding scans like PET-CT (if you are currently doing only CT with contrast now).

I did 4+ years of Signatera... and early on I did have a maximum reading... so my blood draw was quickly repeated and tested... turned out to be a false positive, since all my other draws showed zero. So... he may have your Signatera testing redone, starting with a new blood draw. Your oncologist will decide if this increasing ctDNA test indicates it is time to take action.

Our oncologists are learning as well... how to correlate these ctDNA test results with other bloodwork and scan results... as they learn to put faith in them and take action by starting 2nd-line treatments on their patients. Keep us posted... and we discuss these often on our twice-weekly EC and Esophagectomy Zoom calls, should you want to pop on. Let me know. Our calls are on Wednesdays 6pm Eastern, and Sundays 9am Eastern.

Gary
Southern California