On November 4, 2026 Natera, Inc. (NASDAQ: NTRA), a global leader in cell-free DNA and precision medicine, reported three peer-reviewed publications in npj Precision Oncology, JAMA Otolaryngology, and Advances in Radiation Oncology, highlighting the performance of its Signatera test in head and neck squamous cell carcinoma (HNSCC).
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HNSCC carries recurrence rates of up to 60% depending on stage, and traditional surveillance modalities (e.g., imaging) are limited by high rates of false-positive results and low sensitivity.1-3 Human papillomavirus (HPV) can be a major driver of HNSCC and defines two distinct forms of the disease, HPV-positive (HPV+) and HPV-negative (HPV-).
npj Precision Oncology
In an institutional cohort study, patients were prospectively tested with Signatera after curative-intent surgical resection. Key findings included:
Predictive benefit: Post-operative, pre-adjuvant Signatera-status was predictive of adjuvant chemotherapy benefit in mucosal HNSCC. Among Signatera-positive patients, chemotherapy was associated with a 35% absolute reduction in 2-year locoregional recurrence (28.6% vs. 63.3% without). Signatera-negative patients saw no difference in disease-free survival (DFS), locoregional recurrence, and distant metastases, regardless of adjuvant chemotherapy treatment.
Outperformed high-risk factors: Signatera outperformed clinicopathologic risk factors for prognostication of disease free survival risk.
JAMA Otolaryngology
In this study of 168 patients, Signatera was evaluated in the pre-treatment and surveillance settings, with the following key findings:
High baseline detection of molecular residual disease (MRD): 92.2% of pre-treatment samples were Signatera-positive.
Strong MRD performance across HPV+ and HPV- patients: Serial Signatera testing showed 95.2% sensitivity and 99.4% negative predictive value, with 100% specificity and 100% positive predictive value in the surveillance setting.
Advances in Radiation Oncology
In a retrospective analysis of 97 patients with stage 1-4 HNSCC, key findings on Signatera’s clinical utility during post-definitive treatment surveillance included:
Advance detection of recurrence over imaging: Serial Signatera testing detected recurrence by a median of 4.3 months before radiographic progression, with 91.7% sensitivity and 96.4% specificity.
Excellent MRD performance across HPV+ and HPV- subtypes: Signatera achieved 100% sensitivity in HPV+ patients, outperforming TTMV-HPV DNA assays commonly used to detect recurrence in this patient population.4
Multivariate analysis: Signatera-positivity was the only independent predictor of progression-free survival in a multivariate analysis, outperforming clinical stage, p16 status, and tumor location.
"Head and neck cancer is difficult to treat and carries high recurrence rates, underscoring the importance of catching relapse as early as possible," said Michael Krainock, MD, PhD, MBA, Medical Director, Oncology, Natera. "Collectively, these new studies demonstrate Signatera’s ability to detect recurrence well in advance of clinical signs and predict which patients were likely to benefit from adjuvant chemotherapy."
(Press release, Natera, NOV 4, 2026, View Source [SID1234674234])