Questions that can come up during ovarian cancer follow-up
Signatera™ may be used alongside standard ovarian cancer follow-up care. Your doctor may use it to help answer questions like:
- Is there any cancer left after surgery or treatment? This is sometimes called molecular residual disease, or MRD. Signatera™ can detect ctDNA in the blood that indicates disease may be present after treatment.
- Is my treatment working? Repeat testing over time may help your doctor track ctDNA changes during treatment in some settings.
- Could the cancer be coming back? Serial monitoring may help detect new ctDNA signals during surveillance.
- How does this fit with CA-125 and scans? Signatera does not replace CA-125 or imaging. It adds another personalized signal your doctor can use with your full follow-up plan.
A blood test designed for your tumor
Signatera™ is personalized first, then your doctor can order repeat blood tests over time to monitor ctDNA.
Personalized setup
A sample of your tumor tissue is used to build your personalized Signatera™ test.
Blood draw testing
A blood sample is checked for ctDNA that matches your tumor’s DNA “fingerprint.”
Repeat testing over time
After your test is built, your doctor can order Signatera™ again to monitor whether ctDNA is detected over time.
What research says about ctDNA monitoring in ovarian cancer
Research studies have looked at Signatera™ in ovarian cancer monitoring. It has been studied in many types and stages of ovarian cancer.
What researchers have found:
- The test can be used over time to help monitor patients after treatment
- In studies, it found signs of cancer coming back earlier than scans, on average
- In that research, it performed better than CA-125 for detecting recurrence
- It may be helpful across different types of ovarian cancer, including when CA-125 is not as helpful
A ctDNA test result is just one part of the full picture. Your doctor will look at your test results along with scans, symptoms, exams and other lab tests to guide your care.
Ovarian cancer treatment and surveillance
Your doctor may use Signatera™ at different times depending on your diagnosis, subtype, stage and treatment plan.
During treatment
Signatera™ testing over time may help monitor ctDNA changes and support treatment response discussions in some settings, including when your doctor is tracking how the cancer responds to therapy.
After treatment (surveillance)
Signatera™ can be used during ovarian cancer surveillance to monitor for ctDNA over time after surgery or after treatment is completed. Repeat testing may help your doctor follow trends between routine visits.
Meet Holly: clear cell ovarian cancer survivor and Signatera™ patient
Holly shares her experience with high-grade clear cell ovarian cancer, a rare ovarian cancer subtype where follow-up can be especially difficult and CA-125 may be less informative for some patients.
Covered by Medicare for patients with stage II-IV ovarian, fallopian tube, or primary peritoneal cancer
Coverage for Signatera™ can vary by insurance plan and how the test is used. Natera offers billing support to help patients understand insurance coverage, expected costs and financial assistance options when available.
Signatera™ is covered by Medicare for patients with Stage II-IV ovarian, fallopian tube, or primary peritoneal cancer in the adjuvant and recurrence monitoring settings.
Other testing that may be part of ovarian cancer care
Ovarian cancer care may include different types of testing at different points. Along with Signatera™ monitoring, your doctor may also discuss hereditary testing and tumor profiling.
Altera™ comprehensive genomic profiling (CGP)
Altera™ looks at genetic changes and biomarkers in your tumor that may help guide treatment planning and clinical trial discussions.
Empower™ hereditary cancer testing
Some ovarian cancers are linked to inherited gene changes that can run in families. Empower™ is Natera’s hereditary cancer test that can help identify inherited risk and may help inform care decisions for you and your family.
Ovarian cancer ctDNA monitoring and Signatera™ FAQs
Answers to common questions about ovarian cancer recurrence monitoring, MRD testing, CA-125 and Signatera™.
What is ctDNA in ovarian cancer?
ctDNA stands for circulating tumor DNA. These are small pieces of DNA that can come from cancer cells and be found in the bloodstream. Signatera™ is designed to look for ctDNA that matches your specific ovarian tumor.
What is MRD after ovarian cancer treatment?
MRD means molecular residual disease. It refers to a very small amount of cancer that may remain after surgery or treatment even when scans do not show visible cancer. Signatera™ is designed to detect MRD in the form of ctDNA.
How is Signatera™ different from CA-125 for ovarian cancer monitoring?
CA-125 is a blood marker often used in ovarian cancer follow-up. Signatera™ is different because it is a personalized ctDNA test built from your tumor tissue. It looks for your tumor’s specific DNA fingerprint. Your doctor may use Signatera™, CA-125, imaging and exams together during surveillance.
Can Signatera™ detect ovarian cancer recurrence earlier than a scan?
In published ovarian cancer research, serial Signatera™ testing detected recurrence earlier than imaging on average in the study setting. This does not mean it replaces scans. Your doctor uses Signatera™ results with imaging and other clinical information.
What does a positive Signatera™ result mean in ovarian cancer?
A positive result means ctDNA was detected in that blood sample. This can be an early warning sign that your doctor may want to look closer or monitor more closely. It does not confirm recurrence by itself.
What does a negative Signatera™ result mean?
A negative result means ctDNA was not detected at that time point. This can be reassuring but it does not guarantee the cancer will not return. Follow-up care should continue as recommended by your doctor.
Can Signatera™ be used if my CA-125 is normal?
In some cases, yes. CA-125 may not be elevated in every patient or every recurrence. Signatera™ provides different information by looking for tumor-informed ctDNA. Your doctor can decide if it fits your follow-up plan.
Can Signatera™ be used for clear cell ovarian cancer?
Signatera™ is a tumor-informed test built from your own tumor tissue and ovarian cancer research cohorts have included multiple histologies, including clear cell ovarian cancer. Your doctor can explain whether ctDNA monitoring may be useful for your subtype and stage.
How often is Signatera™ testing done for ovarian cancer surveillance?
There is not one schedule for everyone. Signatera™ can be ordered repeatedly over time during treatment monitoring or surveillance. Your doctor will decide timing based on your diagnosis, treatment plan and follow-up schedule.
Is Signatera™ covered for ovarian cancer?
Coverage depends on your insurance plan and clinical situation. Signatera™ has Medicare coverage for ovarian cancer under applicable MolDX requirements. Natera can help patients understand billing and coverage support options.
Does Signatera™ replace scans, pelvic exams or office visits?
No. Signatera™ is designed to add information to standard follow-up care. Your doctor will still use scans, exams, symptoms and other labs to guide decisions.
Can Signatera™ be used during treatment or only after treatment?
Signatera™ may be used in different settings depending on your care plan, including during treatment in some cases and during surveillance after treatment. Your doctor will determine if and when testing is appropriate.
Is Signatera™ right for you?
1Hou JY, Chapman JS, Kalashnikova E, et al. Circulating tumor DNA monitoring for early recurrence detection in epithelial ovarian cancer. Gynecologic Oncology. 2022.