4th or 5th Signatera

[beach sunrise]

Had another Signatera test this morning. Fingers crossed and holding my own until results.

[MadMed]

Good luck, i imagine you're still getting regular CTs too. Hope yours stay negative.

[Rock_Robster]

Fingers crossed for you! Nothing like waiting for results to cure any lingering hypotension.

Rob

[I_will_fight]

Good luck, I hope it stays negative!

How often do you take the tests?

[beach sunrise]

Good luck, i imagine you're still getting regular CTs too. Hope yours stay negative.

Thank you!
Yes, I have CT's every 3 months with PET/CT every 6 months. We will back off scans to CT's every 6 months if this Signatera comes back negative. I pray it does.

[beach sunrise]

Good luck, I hope it stays negative!

How often do you take the tests?

Thank you! Me too.
Signatera is every 3 months. If this one is negative we will fall back to every 6 months unless bloodwork shows something in between.

[beach sunrise]

Thank you Rob and pccr!
I will update when results are back. Stress is pretty high right now.

[beach sunrise]

Thanks!
No results yet. Hopefully tomorrow. Good grief at the stress over it.
Sometimes its good to be loaded with work to keep your mind off things.

[JJH]

Just a question about your Signatera profile. Do your Signatera reports identify the specific 16 somatic variants that all of your sequential tests are based on? ... Just curious ...

[beach sunrise]

Yes, I had 3 show up out of 16.
They also test so many variants of unknown significance with alteration type and allele freq. But some I read about are not listed. Thought that was unusual.
I can send you a report if you want to look at it?

[JJH]

Yes, I had 3 show up out of 16.
They also test so many variants of unknown significance with alteration type and allele freq. But some I read about are not listed. Thought that was unusual.
I can send you a report if you want to look at it?

No, it's not necessary to send me a report. I already downloaded a sample report from their website.

What I'm puzzled about is that their sample report doesn't show anything about the 16 variants that are supposedly the basis of the test. What it says in the fine print is:

Sixteen putative clonal variants present in the tumor but absent in the baseline DNA form the basis for individual-specific PCR-based assays …
This test is not designed to detect germline variation nor infer hereditary cancer risk for the patient"

But the fine print also states that "All the results should be interpreted by a clinician," but how is a clinician going to know how to interpret the results of the test if the results don't give the details about the 16 patient-specific variations that the test is based on?

A year or so ago I saw a different kind of sample report that listed the details of the hundreds of variants that are in the large pool of variants from which the patient's 16 patient-specific variations are selected, but I cannot find that report on the Internet any more, and I'm not sure where to go to look for it now. ** (Correction: see P.S. below)

What I'm also puzzled about is the language used in describing the test. The promotional literature mentions DNA "variants" sometimes, but at other times it talks about DNA "mutations". I do not know enough about the field to know the difference between somatic variants and somatic mutations, but I suspect that there is an important nuance that needs to be understood before the results of a test can be properly interpreted.

At this point in time I am still hesitant about ever using this test, because I'm not really sure what it tests for and whether or not the variants are related to cancer specifically, or possibly to some type of non-cancerous disorder, like maybe a hormonal disorder, for example. So, when they talk about MRD (Molecular Residual Disease), are they sure that the disease is cancer-related, or could it be some sort of other disease that's being detected? In other words, are they sure that the 16 patient-specific variations are variations of onco-genes or could they just be variants of some other type of gene? That's why I would like to see the list of variants that their PCR assays are testing for.
==========
P.S. I just found the report that lists the 440 variants from which a patient's 16 patient-specific variants are selected:

https://www.natera.com/wp-content/uploads/2021/02/20210203-Altera-Gene-List-DOWNLOAD.pdf

[beach sunrise]

Signatera positive at .2 something
But, having that low of a reading does not indicate with 95% accuracy so I was told. > 95% at .30 MTM/mL. Pretty darn close though. Something somewhere is brewing. According to the test I should have 8-12 months head start to change things up with protocol in order to beat it down so it doesn't get any further.
Appts with onc and NDs coming up.
Anyone have any experience with Signatera to share?

[JJH]

Signatera positive at .2 something
But, having that low of a reading does not indicate with 95% accuracy so I was told. > 95% at .30 MTM/mL. Pretty darn close though. Something somewhere is brewing. According to the test I should have 8-12 months head start to change things up with protocol in order to beat it down so it doesn't get any further.
Appts with onc and NDs coming up.
Anyone have any experience with Signatera to share?

Just a thought: You might be able to find some type of imaging scan that will find something earlier than the 8-12 months mentioned in the Signatera report. These scans are like angiograms and are designed to look for places where there is higher than usual blood flow activity. They are I-RAD MRIs and work something like a PET/CT scan, where the active area lights up with a different color or different shade of gray:

https://radiologisthq.com/category/i-rads

The scans are multiparameter MRIs that can be programmed separately for liver scans, lung scans, colon scans, etc.

It would be nice if they could figure out where the molecular residual disease (MRD) is coming from.

[beach sunrise]

Thank you, JJH!
Weird you would mention the I-RAD MRI. Got a call Monday to reschedule 3 month scan (due in March). I just sent an email to the Rad director asking about the I-RAD type of scan machine.
I was thinking today I wish I could go to MN for the 7T MRI. It is experimental right now but they asked I send a summary of my case for review. I didn't follow up with it because at the time SHTF up there.

[ktex]

Signatera positive at .2 something
But, having that low of a reading does not indicate with 95% accuracy so I was told. > 95% at .30 MTM/mL. Pretty darn close though. Something somewhere is brewing. According to the test I should have 8-12 months head start to change things up with protocol in order to beat it down so it doesn't get any further.
Appts with onc and NDs coming up.
Anyone have any experience with Signatera to share?

How do you beat it down?