On May 26, 2021 Natera, Inc. (NASDAQ: NTRA), a pioneer and global leader in cell-free DNA testing, reported it will present new clinical data on its personalized and tumor-informed molecular residual disease (MRD) assay, Signatera, at the 2021 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) annual meeting, taking place June 4-8, 2021 (Press release, Natera, MAY 26, 2021, View Source [SID1234580648]). Two additional studies were presented at the 2021 American Association for Cancer Research (AACR) (Free AACR Whitepaper) annual meeting that took place April 9-14, 2021.
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At ASCO (Free ASCO Whitepaper), Natera will present four posters highlighting the use of Signatera in new indications including multiple myeloma. It will also unveil new colorectal cancer data from the CIRCULATE-Japan trial, the largest prospective MRD study to date.
"We are proud to share this wealth of new data with the larger oncology community," said Alexey Aleshin, M.D., Natera’s vice president of medical affairs, oncology. "The quality and quantity of these real-world data is a testament to the power of Signatera’s tumor-informed and personalized technology and to Natera’s commitment to pushing the boundaries of our understanding of MRD."
Details about the ASCO (Free ASCO Whitepaper) abstracts are as follows:
Abstract #8029 | Poster Presentation | Presenter: Binod Dhakal, M.D.
Personalized ctDNA analysis to detect minimal residual disease and identify patients at high risk of relapse with multiple myeloma
A retrospective study on the feasibility of using Signatera for MRD assessment in multiple myeloma. Archival bone marrow aspirates and formalin-fixed, paraffin-embedded (FFPE) slides from 28 patients taken at the time of diagnosis were used to design the custom MRD assay for that individual. Patients were serially monitored for a median of 92.4 months after autologous stem cell transplantation (AHCT). Despite the low quality of the samples, the MRD-positive patients had a significantly higher rate of relapse and poorer recurrence-free survival than those who had no detectable MRD after AHCT (HR 5.6, 95% CI: 1.8 – 17, p= 0.0003).
"The variability in sampling of bone marrow aspirates often provides an inaccurate estimate of marrow MRD. Further, serial monitoring of MRD status using bone aspiration is challenging due to the invasive nature of the procedure," said Dr. Binod Dhakal, associate professor of medicine, the Medical College of Wisconsin, and first author of the study. "We are encouraged by the data from this study as it shows that a sensitive ctDNA test can provide a non-invasive alternative that captures the spatial heterogeneity of multiple myeloma."
Abstract #3608 | Poster Presentation | Presenter: Hiroki Yukami, M.D.
Minimal residual disease by circulating tumor DNA analysis for colorectal cancer patients receiving radical surgery: An initial report from CIRCULATE-Japan
CIRCULATE-Japan is the largest prospective MRD study to date. Initial analysis from the first 400 early-stage (stage II-III) or relapsed colorectal cancer (CRC) patients in this observational study shows that Signatera’s tumor-informed approach has a pre-surgical detection rate of >94% across stage I-III CRC patients, and a post-surgical relapse detection rate of 92% with longitudinal sampling. These detection rates compare favorably to longitudinal results from tissue-naive approaches. Additionally, the failure rate of patient samples using Signatera was very low at <3%.
Abstract #3540 | Poster Presentation | Presenter: Tenna V. Henriksen, M.S.
Serial circulating tumor DNA analysis for assessment of recurrence risk, benefit of adjuvant therapy, growth rate and early relapse detection in patients with stage III colorectal cancer
This study serially monitors 168 stage III CRC patients using Signatera for 36 months after surgery, during and after adjuvant chemotherapy, and during surveillance. It demonstrates, for the first time, that the quantitative measurement of ctDNA levels provided by Signatera can be used to assess the growth rates of metachronous metastases. Patients may be classified as having either a slow- or fast-growing tumor based on the rate of increase of ctDNA. Those with fast-growing tumors (137% increase per month) had significantly poorer overall survival compared to those with slow-growing tumors (27% increase per month), underscoring the clinical utility of ctDNA quantitation in the management of stage III CRC.
Abstract #4103 | Poster Presentation | Presenter: Pashtoon Kasi, M.D., M.S.
Tumor-informed assessment of circulating tumor DNA and its incorporation into practice for patients with hepatobiliary cancers
This exploratory study establishes the feasibility of using a tumor-informed MRD test in a heterogeneous cohort of 113 patients with hepatocellular carcinoma, cholangiocarcinoma and gallbladder cancer. Detection rates pre- and post-surgery, during treatment, and surveillance, are reported and shown to correlate with disease stage.
Details about the AACR (Free AACR Whitepaper) abstracts are as follows:
Abstract #552 | Poster Presentation | Presenter: Jocelyn Chapman, M.D.
Circulating tumor DNA predicts disease recurrence in ovarian cancer patients
This study demonstrates the prognostic value of ctDNA in 70 patients with stage I-IV epithelial ovarian cancer (EOC), in comparison to blood biomarker CA-125. The presence of ctDNA was observed to be a strong predictor of relapse (p<0.0001), while CA-125 was not significantly associated with relapse-free survival (p=0.09). ctDNA detection preceded radiological relapse by a median of 10 months (p<0.05), while CA-125 had a lead time of approximately one month.
Abstract #569 | Poster Presentation | Presenter: Antony Tin, Ph.D.
Correlation of variant allele frequency and mean tumor molecules with tumor burden in patients with solid tumors
This poster compares two common measures of tumor burden in cfDNA — variant allele frequency (VAF) and mean tumor molecules (MTM) per mL of plasma. 13,218 plasma samples from 6,265 patients with a wide range of cancer types were analyzed, and discordances between trends in VAF and MTM per mL were observed in 8.8% of samples. These samples were derived from patients who had high total levels of cfDNA due to increased cell death from ongoing treatment. In these scenarios, MTM per mL, which accounts for total cfDNA levels, was found to be more reflective of clinical truth, as confirmed by imaging.
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. This maximizes accuracy for detecting the presence or absence of residual disease in a blood sample, even at levels down to a single tumor molecule in a tube of blood. Signatera is intended to detect and quantify how much cancer is left in the body, to detect recurrence earlier and to help optimize treatment decisions.
The Signatera test performance has been clinically validated in multiple cancer types including colorectal, non-small cell lung, breast, and bladder cancers. Signatera has been developed and its performance characteristics determined by Natera, the CLIA-certified laboratory performing the test. The test has not been cleared or approved by the US Food and Drug Administration (FDA). CAP accredited, ISO 13485 certified, and CLIA certified.