Medicare Extends Coverage of Natera’s Signatera™ MRD Test to Ovarian Cancer and Neoadjuvant Breast Cancer
Natera, Inc. (NTRA) announces that its Signatera MRD test has met coverage requirements from CMS in new indications for ovarian and breast cancer. The test has shown promising results in detecting recurrence early and predicting therapy response, potentially improving outcomes for patients.
The recent coverage expansion for Natera's Signatera test by the CMS MolDX program highlights its potential to transform patient management in ovarian and breast cancers. From an oncological perspective, the ability to detect recurrence with 100% sensitivity and specificity, particularly with a 10-month lead time ahead of imaging, is a game-changer. This could allow for earlier interventions and potentially improve survival rates. Moreover, the early ctDNA clearance as a predictor of therapy response in breast cancer patients underscores the test's utility in tailoring treatment plans, especially when dealing with aggressive subtypes like triple-negative breast cancer.
From an economic standpoint, the CMS coverage of Signatera in additional cancer indications represents a significant advancement in cost-effective healthcare. By providing earlier and more accurate detection of cancer recurrence, the test may reduce the long-term costs associated with late-stage cancer treatments. This proactive approach in disease management aligns with value-based care models, which aim to improve patient outcomes while controlling healthcare spending. The coverage decision also signals a broader acceptance of personalized medicine, potentially leading to a shift in resource allocation within the healthcare system.
For investors and market analysts, CMS's decision to cover Signatera for new indications is a strong indicator of the product's market potential and Natera's growth trajectory. The expanded coverage not only opens up new revenue streams but also solidifies the company's position in the precision oncology market. As healthcare providers increasingly adopt Signatera, Natera's financial performance is likely to reflect the growing demand for MRD testing. However, competitors are also vying for market share in this space and Natera's ability to maintain its competitive edge will be critical for sustained investor confidence.
02/26/2024 - 07:00 AM
AUSTIN, Texas --(BUSINESS WIRE)--
Natera, Inc. (NASDAQ: NTRA), a global leader in cell-free DNA testing, today announced that its personalized and tumor-informed molecular residual disease (MRD) test, Signatera, has met coverage requirements from the Centers for Medicare & Medicaid Services’ (CMS) Molecular Diagnostics Services Program (MolDX) in two new indications: ovarian cancer in the adjuvant and surveillance settings, and breast cancer in the neoadjuvant setting.
These determinations add to a growing list of covered indications for Signatera, including adjuvant and recurrence monitoring coverage in colorectal cancer, muscle-invasive bladder cancer, and breast cancer; and pan-cancer immunotherapy response monitoring.
Ovarian Cancer
The MolDX coverage decision applies to patients with ovarian cancer, in both the adjuvant and surveillance settings.
Ovarian cancer is the 5th leading cause of cancer-related death among women, with an estimated 2022 incidence and mortality of 19,880 and 12,810, respectively, and a median age at diagnosis of 63 years.1 While multiple new treatment options have been introduced in recent years, physicians have had to rely on imperfect biomarkers to determine who is likely to benefit from these more intensive regimens, and recurrence risk remains high2 . Additionally, current guidelines for surveillance are limited and providers often rely on tools with low sensitivity and specificity, such that a significant unmet need remains for these patients.3
Signatera performance in ovarian cancer was validated in a blinded, multi-site study published in Gynecologic Oncology .4 The study analyzed 163 plasma samples from 69 patients with stage I-IV ovarian cancer. Test performance was evaluated at multiple time points: pre-surgery, post-surgery prior to adjuvant treatment, and longitudinally. With longitudinal testing, recurrence was detected with 100% sensitivity, 100% specificity, and an average lead time of 10 months ahead of imaging.
Breast Cancer (neoadjuvant setting)
This MolDx coverage decision applies to patients with breast cancer in the neoadjuvant setting across all subtypes of the disease, including hormone receptor (HR)-positive, HER2-positive, and triple negative breast cancers.
Up to 50% of newly diagnosed breast cancer patients receive neoadjuvant therapy (NAT).5 Guidelines recommend routine assessment of tumor response to neoadjuvant therapy but acknowledge that this is “difficult” using currently available diagnostic tools.6 Signatera has been validated to address this unmet need.
The coverage decision was based on clinical evidence published in Cancer Cell 7 from the I-SPY2 trial, which reported on 283 patients and 1,024 plasma samples, with a median of more than 3 years of clinical follow up and a maximum of more than 7.5 years. The study demonstrated that early ctDNA clearance during NAT was a significant predictor of therapy response (p=0.0002), and Signatera negativity after NAT was significantly associated with improved distant recurrence-free survival (DRFS), even in patients with residual cancer burden at surgery (p<0.0001). By contrast, persistent Signatera positivity during and after NAT was significantly associated with therapy non-response and inferior DRFS (p=0.02 to p<0.0001).
“These important Medicare decisions support our ability to personalize disease management for patients with ovarian cancer, the most lethal gynecologic malignancy worldwide, and extend existing coverage in breast cancer to the neoadjuvant setting,” said Minetta Liu, M.D., chief medical officer of oncology at Natera. “Clinical evidence continues to demonstrate the value of Signatera across various settings of disease, which can help clinicians make timely decisions and may improve outcomes for patients. We are incredibly proud of this milestone, and look forward to continuing to work with Medicare to make Signatera more widely accessible for people affected by cancer.”
About Signatera
Signatera is a personalized, tumor-informed, molecular residual disease test for patients previously diagnosed with cancer. Custom-built for each individual, Signatera uses circulating tumor DNA to detect and quantify cancer left in the body, identify recurrence earlier than standard of care tools, and help optimize treatment decisions. The test is available for clinical and research use and is covered by Medicare for patients with colorectal cancer, breast cancer, ovarian cancer and muscle invasive bladder cancer, as well as for immunotherapy monitoring of any solid tumor. Signatera has been clinically validated across multiple cancer types and indications, with published evidence in more than 65 peer-reviewed papers.
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 in approximately 175 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 www.natera.com .
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 www.natera.com/investors and www.sec.gov .
References
American Cancer Society. Key Statistics for Ovarian Cancer. https://www.cancer.org/cancer/types/ovarian-cancer/about/key-statistics.html
Ovarian Cancer Research Alliance. Recurrence. https://ocrahope.org/patients/diagnosis-and-treatment/recurrence/#:~:text=Data%20has%20shown%20that%20statistically,periods%20of%20time%20after%20recurrence .
NCCN Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer Treatment Guidelines. V1.2024 - Jan 17, 2024.
Hou JY, Chapman JS, Kalashnikova E, et al. Circulating tumor DNA monitoring for early recurrence detection in epithelial ovarian cancer. Gynecol Oncol. 2022;167:334-341. (doi: 10.1016/j.ygyno.2022.09.004).
Riedel F, Hoffmann AS, Moderow M, et al. Time trends of neoadjuvant chemotherapy for early breast cancer. Int J Cancer. 2020;147(11):3049–3058.
National Comprehensive Cancer Network (NCCN). Version 1.2024, Jan 25, 2024.
Magbanua MJM, Swigart LB, Ahmed Z, et al. Clinical significance and biology of circulating tumor DNA in high-risk early-stage HER2-negative breast cancer receiving neoadjuvant chemotherapy. Cancer Cell. 2023;41:1-12.
View source version on businesswire.com: https://www.businesswire.com/news/home/20240226912876/en/
Investor Relations: Mike Brophy, CFO, Natera, Inc., 510-826-2350, investor@natera.com
Media: Lesley Bogdanow, VP of Corporate Communications, Natera, Inc., pr@natera.com
Source: Natera, Inc.
What is the significance of the coverage decision by CMS for Natera's Signatera test (NTRA)?
The coverage decision by CMS for Natera's Signatera test in new indications for ovarian and breast cancer signifies that the test has met the necessary requirements to be reimbursed by Medicare, potentially increasing access for patients.
How does Signatera perform in detecting recurrence in ovarian cancer patients?
Signatera demonstrated 100% sensitivity and specificity in detecting recurrence in ovarian cancer patients, with an average lead time of 10 months ahead of imaging, based on a validated study.
What clinical evidence supports the use of Signatera in breast cancer patients receiving neoadjuvant therapy?
Clinical evidence from the I-SPY2 trial showed that Signatera negativity after neoadjuvant therapy was significantly associated with improved distant recurrence-free survival, while persistent positivity was linked to therapy non-response and inferior survival outcomes.
Who commented on the significance of the Medicare decisions regarding Natera's Signatera test?
Minetta Liu, M.D., the chief medical officer of oncology at Natera, highlighted the importance of the Medicare decisions in personalizing disease management for ovarian and breast cancer patients.
What is the potential impact of Signatera in disease management according to Minetta Liu, M.D.?
Minetta Liu, M.D. mentioned that Signatera's value across various disease settings can help clinicians make timely decisions and potentially improve outcomes for patients affected by cancer.
