Signatera Test. Is it truly helpful and worthwhile?

I'm Stage 4 Metastatic BC. all within a year. The Doctor At MD Anderson ONLY uses Signaterra and not Tumor Markers to determine if the Cancer is on the move or not. I think it's well worth a simple blood test.

Hi and thx for sharing! May I ask what stage you are? My MO is at Dana Farber and again said the Signatera is not "standard of care" - I have Invasive Lobular Breast Cancer which is often not picked up on mammograms - I got lucky - lumpectomy and radiation and letrozole now for 5-10 yrs. I wish I had asked for a baseline after surgery via Signatera but now that more data is out there I don't understand why so many oncologists won't help their patients - I understand insurance is a big component but some of us would like the information to minimize the constant anxiety of a reoccurrence. In the USA Medicare covers if stage 2 - I am technically stage 1, but grade 2 therefore just curious what stage you are - much appreciated. xo

Hi I am in UK.. this is my (limited) understanding: The Natera test is a tissue test from original lump. They then match the mutations in the lump to any found in the blood. The Guardant test is a blood test to look for circulating ctDNA in the blood which is cross matched somehow to their database of all known mutations per se. In UK the Guardant test costs about £1500. They basically aim to do the same thing i think. There are other companies as well doing both of these things.
There is a sort of sequence: most people pre operation have bits of mutated DNA being shed from the tumour. The operations massively lower the bits floating around and the aim is that Chemo and / or endocrine then get rid of the rest or send it back to being dormant. If you have residual disease immediately after treatment then that is kind of a bad prognostic sign and you will need more treatment or it will recur. The aim of the docs is to get to no residual disease but not always possible. I think they are the 30% or so who relapse. So if there is residual disease, the holy grail is to see if one can take a drug to stop it going metastatic. These trials are not complete and most have not even started. Maybe a while off. They are further on with respect to Colon and Lung cancers. So the oncologists fall into 2 camps: those who dont want their patients distressed that on a positive test they might not know what to then do vs. those wanting to try (anything) on their patient as a piece of research which may help hundreds more women down the line so may be willing to try something to stop it going metastatic. For those who already are metastatic then the tests enable them to see if the current treatment is working or not and / or if they should change (in some cases only where there is an alternate drug) as the patient is becoming resistant to the one they are on. Mostly, i think we are about 5 years+ off having treatments for all the positives so its super stressful to be positive if they cant change anything: in this case, i find it helpful to think that even trying something as a research study of even 1 person, may help thousands in 5 years time. But that is the reason some oncologists don't want to do the tests, especially if they already know there is no specific drug for the mutation they are likely to find in a specific patient as it will simply massively raise anxiety needlessly. Best to ask this question: the ones who may be keener on the tests may be the ones who know they would change something if it was positive. This depends on the mutations / original risk / recurrence score etc etc.

I also agree its worth it if you're someone who would want to know in advance if there could be mets. Many oncos refuse to order it b/c they claim that even if its positive they wouldn't necessarily change the treatment course until a scan showed something. However I think its better to know in advance, at least it gives you time to start researching additional treatment options and/or find an onco that may be willing to change things up. If your doc won't order, you can go online to Pink Lotus through Dr Kristi Funk and order through her website. They charge $150 processing fee just one time to do it through their site. You'll need to check directly with Natera yourself but last I heard they said they will not charge patients for any costs that the insurance doesn't cover. According to Dr Funk, if you can get all negative results for the first 2 years after diagnosis, your chance of having a recurrence is reduced by 90%!

I just had my 1st test in October and it IS WORTH IT. They request a tissue sample from the hospital and they keep it on file to compare every 4 months to be sure if there is any cell movement.
My Dr. in Texas at MD Anderson (I live in Florida) uses it to monitor. It supposedly can see up to a year in advance any metastasizing .

I am from the Philippines. I just read about Signatera from our breast cancer survivors chat group. I sent an email to my oncologist to inquire if I need it and if it is available in my country. Waiting for her reply. If it is available I have a strong feeling I may not be able to afford it. Insurance companies here do not cover new molecular cancer tests like Signatera. As it is taking Ribociclib with Letrozole for 6 months have already created a dent in our savings. This is the reality of living in a developing country with a poor healthcare system.

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.

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.

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.

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.