Skip navigation

Know earlier if ICI treatment is working

During treatment with immune-checkpoint inhibitors (ICI), you want answers to critical questions as soon as possible. Is treatment working? Is the tumor truly progressing? Should you change or restart treatment? Signatera is a personalized tumor-informed assay for ultrasensitive detection of molecular residual disease (MRD) that helps you find answers to these questions earlier than traditional tests and imaging.


The challenges of ICI treatment.
The power of ctDNA.

Despite dramatic improvements in cancer patient care using ICI-based treatments, the reality is it doesn’t work for everyone:

  • About 43.5% of cancer patients are eligible for ICI treatment.1,2
  • Less than 20% of eligible patients will derive sustained response or clinical benefit to ICIs.1,2

Checking and evaluating ICI response at key intervals of a patient’s treatment is critical to informing decision-making and paving the way for stronger outcomes.

Blood-based circulating tumor DNA (ctDNA) is a powerful real-time biomarker that enables earlier and more sensitive detection of ICI treatment response than CT scans or other serum protein biomarkers.

INSPIRE Trial: Validating ctDNA as an early biomarker of ICI treatment response

Signatera was evaluated in the INSPIRE trial, a randomized, prospective study in a pan-cancer cohort of patients receiving pembrolizumab treatment.3

  • 98% of patients had detectable ctDNA detected at baseline
  • An increase in ctDNA levels from baseline at week 6 strongly predicted disease progression and non-response to pembrolizumab
  • Achieving ctDNA clearance at any time during treatment correlated with durable OS

Combined with imaging tools, Signatera ctDNA analysis provides several clinical benefits:

  • Assess therapeutic benefit in real-time
  • Rule-out pseudo-progression early
  • Assists in interpretations of ambiguous imaging results
  • Increase confidence in decisions to continue, switch, or reinitiate ICI
  • Improve the management of patients with durable, radiographically stable disease

Overall survival was 100% in patients who experienced ctDNA clearance for at least one on-treatment time point

Positive Result

What is Signatera?

Signatera can be used alongside imaging tests to better assess response to immunotherapy and help determine whether the tumor is progressing or not.

Signatera at a Glance

Each Signatera test is personalized and tumor-informed. Whole-exome sequencing of the tumor-tissue allows a bespoke Signatera assay to be created, which detects ctDNA from only clonal mutations. Tracking ctDNA unique to the patient’s clonal mutation signature is key to enabling a highly sensitive and specific test with a low limit of detection, down to 0.01% VAF.4 5 6 7

  • Personalized, tumor-informed assay
  • Tumor-specific, clonal mutations identified by whole-exome sequencing of patient’s tumor tissue to eliminate germline and CHIP mutations
  • Ultrasensitive ctDNA detection with multiplex PCR technology
  • Highly sensitive and specific with a low limit of detection
  • Optimized for longitudinal monitoring
  • Only measures clonal mutations, which correlates with tumor burden

Personalized, tumor-informed assay

One-time, primary tissue sample and matched normal tissue is required for whole exome sequencing and personalized test design.

Ultrasensitive ctDNA detection

Signatera is designed to detect ctDNA of somatic and truncal variants to optimize sensitivity. Tumor-informed method enables filtering of CHIP mutations to decrease false positive rates.

Optimized for longitudinal monitoring

Once the patient’s personalized test has been designed, only a blood sample is needed each subsequent time Signatera is ordered.

BESPOKE study of ctDNA guided immunotherapy (IO)

The BESPOKE IO clinical study will examine participant data and blood samples to determine the effects on clinical outcomes when Signatera is integrated into ICI cancer treatment.

Natera and its collaborators will collect clinical utility and outcome data on enrolled patients for two years. This data will help us better understand how patients respond to ICIs and what they should do next.

Learn more about immunotherapy monitoring

Check out our FAQ page to learn more about Signatera

Questions about Signatera? Submit your inquiries below.