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December 9, 2022

Natera Announces Publication of Multi-Center Study Validating Signatera’s Ability to Predict Recurrence in Esophageal and Gastric Cancers

Across all subtypes, in a real-world cohort of >200 patients and >900 plasma samples, the presence of ctDNA at any time was strongly associated with disease recurrence and poor prognosis

AUSTIN, Texas, Dec. 9, 2022 /PRNewswire/ — Natera, Inc. (NASDAQ: NTRA), a global leader in cell-free DNA testing, today announced the publication of a new study in JCO Precision Oncology highlighting the clinical utility of its personalized and tumor-informed molecular residual disease test, Signatera™, for postoperative risk stratification and prediction of recurrence in patients with stage I-III esophageal and gastric cancers (EGCs). The full study can be found here.

EGCs are the sixth most common cancers worldwide,1 affecting approximately 47,000 new patients per year in the U.S.2  In patients with localized disease, despite treatment with curative-intent therapy, over 50% recur within three years.3-5 Today, clinical practice guidelines support either adjuvant therapy or observation post surgery, so there is a strong unmet need for better risk stratification tools to help inform these risk-based management decisions. In addition, due to the high rate of recurrence, guidelines recommend frequent monitoring for recurrence with imaging, endoscopic evaluation or tumor markers.6

This real-world study, one of the largest reported EGC studies to date, included 943 plasma samples collected from 295 patients across more than 70 institutions. The primary analysis focused on the 212 patients with stage I-III disease. Signatera ctDNA status was evaluated at diagnosis (prior to neoadjuvant treatment), post surgery and then serially during routine surveillance, with median clinical followup of 417 days.

 Key takeaways from the study include:

  • Pre-treatment: ctDNA was detectable in 96% (23/24) of patients with preoperative samples.
  • Post surgery (within 16 weeks): ctDNA was detected post-surgically in 23.5% (16/68) of patients. ctDNA-positive patients experienced a higher rate of recurrence (81.2%) in comparison to ctDNA-negative patients (13.5%). ctDNA-positive patients experienced inferior RFS (HR: 10.7, 95% CI: 4.3-29.3, p<0.0001).
  • Surveillance setting (at least 2 weeks after completion of adjuvant treatment): the recurrence rate in patients with a ctDNA-positive result was 95.2% (20/21) compared to 7.9% (5/63) in patients who remained ctDNA-negative. ctDNA-positive patients experienced inferior RFS (HR: 17.7, 95% CI: 7.3-50.7, p<0.0001).
  • Multivariate analysis: ctDNA was the strongest prognostic factor compared to all other clinicopathological risk factors including disease stage, location, and MSI status (HR: 11.82, 95% CI: 6.18-22.6, p<0.001).

"This study shows how longitudinal assessment using Signatera allows for accurate post operative risk stratification and adjuvant therapy or surveillance monitoring in patients with esophagogastric cancers in a real-world setting," said Samuel Klempner, M.D., associate professor at Massachusetts General Hospital and corresponding author of the study.  "Unfortunately, many gastroesophageal cancers recur after definitive treatment, and patients with advanced disease have a poor prognosis. This study highlights the potential for Signatera to better identify patients at highest risk of recurrence and help develop novel treatment approaches."

About Signatera

Signatera is a custom-built circulating tumor DNA (ctDNA) test for treatment monitoring and molecular residual disease (MRD) assessment in patients previously diagnosed with cancer. The test is available for both clinical and research use, and has been granted three Breakthrough Device Designations by the FDA for multiple cancer types and indications. The Signatera test is personalized and tumor-informed, providing each individual with a customized blood test tailored to fit the unique signature of clonal mutations found in that individual’s tumor. Signatera is intended to detect and quantify cancer left in the body, at levels down to a single tumor molecule in a tube of blood, to identify recurrence earlier and to help optimize treatment decisions.

About Natera

Natera™ is a global leader in cell-free DNA testing, dedicated to oncology, women’s health, and organ health. We aim to make personalized genetic testing and diagnostics part of the standard of care to protect health, and inform earlier, more targeted interventions that help lead to longer, healthier lives. Natera’s tests are validated by more than 100 peer-reviewed publications that demonstrate high accuracy. Natera operates ISO 13485-certified and CAP-accredited laboratories certified under the Clinical Laboratory Improvement Amendments (CLIA) in Austin, Texas and San Carlos, California. For more information, visit

Forward-Looking Statements

All statements other than statements of historical facts contained in this press release are forward-looking statements and are not a representation that Natera’s plans, estimates, or expectations will be achieved. These forward-looking statements represent Natera’s expectations as of the date of this press release, and Natera disclaims any obligation to update the forward-looking statements. These forward-looking statements are subject to known and unknown risks and uncertainties that may cause actual results to differ materially, including with respect to whether the results of clinical or other studies will support the use of our product offerings, the impact of results of such studies, our expectations of the reliability, accuracy and performance of our tests, or of the benefits of our tests and product offerings to patients, providers and payers. Additional risks and uncertainties are discussed in greater detail in "Risk Factors" in Natera’s recent filings on Forms 10-K and 10-Q and in other filings Natera makes with the SEC from time to time. These documents are available at and


Investor Relations: Mike Brophy, CFO, Natera, Inc., 510-826-2350
Media: Lesley Bogdanow, VP of Corporate Communications, Natera, Inc.,          


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  2. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33.
  3. de Steur WO, van Amelsfoort RM, Hartgrink HH, et al. Adjuvant chemotherapy is superior to chemoradiation after D2 surgery for gastric cancer in the per-protocol analysis of the randomized CRITICS trial. Ann Oncol. 2021;32(3):360-367.
  4. Eyck BM, van Lanschot JJB, Hulshof M, et al. Ten-Year Outcome of Neoadjuvant Chemoradiotherapy Plus Surgery for Esophageal Cancer: The Randomized Controlled CROSS Trial. J Clin Oncol. 2021;39(18):1995-2004.
  5. Kelly RJ, Ajani JA, Kuzdzal J, et al. Adjuvant Nivolumab in Resected Esophageal or Gastroesophageal Junction Cancer. N Engl J Med. 2021;384(13):1191-1203.
  6. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology. Version 3.2022.


SOURCE Natera, Inc.

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