What is Altera and what does it test for?

Altera is a test commonly referred to as comprehensive genomic profiling (CGP). This testing identifies the unique genetic changes present in your tumor which your doctor can then use to determine which treatment is best for your cancer. It can also help identify clinical trials which may be available to you.

How is the Altera test different from my Signatera test?

Altera testing serves a different purpose from Signatera testing. Altera allows a physician to determine which types of treatment may work best for your cancer based on the unique genetic changes observed only in the tumor cells. This is different from Signatera testing, as Signatera is a lab test customized to the unique genetic of your tumor not to inform treatment but, rather, to determine if your cancer is detectable after surgery or treatment.

Can the Altera test be done on all types of cancers?

Altera can be performed on all solid tumors. Altera cannot be performed on blood cancers at this time.

I already had Signatera testing, can my doctor now order Altera?

Yes, your doctor can order Altera but it would require submitting both the blood and tissue requirements for testing.

I already had Altera testing, can my doctor now order Signatera?

Yes, your doctor can order Signatera but it would require submitting two 10mL Streck tubes for testing.

Can my doctor order Signatera and Altera at the same time?

Yes, your doctor can order both tests at the same time. This requires both tissue and blood specimens. Natera will work with your doctor to obtain the tissue specimen. The blood samples needed for testing includes one 10mL EDTA (purple top) tube and two 10 mL Streck tubes.

Can I have Signatera and or Altera testing if I am pregnant/ and or have had an organ transplant?

Pregnancy: Unfortunately at this time, Signatera cannot be performed in patients who are pregnant, however, this is not a contraindication for Altera (yes Altera can be performed in pregnant patients). Donor bone marrow/stem cell transplants: No, neither Signatera nor Altera can be performed in patients with a history of donor bone marrow or stem cell transplant. Organ Transplant: If the donor organ received is impacted by cancer (i.e. the tumor tissue being sent for testing derived from the donated organ), neither Signatera nor Altera, can be performed. However, if the patient happened to have had a transplant BUT the donated organ is NOT involved in the cancer diagnosis, then we can perform Signatera and/or Altera.

Does getting a COVID-19 vaccine affect my eligibility for Altera and/or Signatera testing?

Receiving a COVID-19 vaccine does not make you ineligible for Altera and/or Signatera testing. You are eligible to proceed with testing if you have received or plan to receive the COVID-19 vaccine.

How long does it take to receive Altera results/What is the turnaround time (TAT)?

The results of your Altera test will be available to your doctor in ~2 weeks from the day all required samples for testing have been received in our laboratory.

What samples are required for the initial test?

Altera requires both a blood sample (one 6 mL EDTA (lavender top) tube) and tissue sample from your tumor. Natera will work with your doctor to obtain the tissue sample.

Why do you need both a tissue and blood sample?

In order to determine the unique genetic changes in your tumor cells only, we first have to know the DNA you were born with. The blood sample allows us to know the normal DNA sequence you inherited from your parents. The tissue sample allows us to look at the DNA from your tumor cells. By comparing the two, we can then determine which genetic changes are only occurring in your tumor cells.

Will the Altera report also identify what clinical trials the patient may be eligible for?

Yes, Altera will report what clinical trials may be available to the patient based on the mutations identified in the patient’s tumor.

How do I obtain my test results?

Once testing it complete, a report will be sent to your physician. You can then contact their office to discuss results.

Is Altera testing covered by Medicare?

Natera bills all commercial and government insurance plans (i.e. Medicare, Medicare advantage, Medicaid and private insurances) Majority of our patients will have zero out of pocket (OOP) Please note, Medicare patients are fully covered under the following scenarios: With stages II / III colorectal cancer for Signatera testing With solid tumors on immunotherapy for Signatera testing With stages III / IV solid tumors for Altera testing For any remaining patient responsibility, Natera has robust financial assistance programs that can be offered to qualified patients to ensure the test is as affordable as possible

How much will it cost patients?

If a patient is uninsured or concerned about their ability to pay for testing, they can complete an online application or contact one of our Patient Coordinators at signaterapc@natera.com

Can a patient cancel an order?

Patients can cancel testing anytime up until the sample is received in the lab.

What happens if coverage is denied? How does the appeal process work?

Natera Patient Coordinators will work with the patient’s insurance provider to file appeals and pursue coverage on the patient’s behalf.

Does Natera reach out to patients to explain their potential out of pocket prior to processing the initial sample?

A Patient Coordinator will reach out and contact the patient regarding coverage and potential out of pockets costs.

Who can I contact if I have any additional billing questions?

For any questions or to request financial assistance, please contact Natera’s Patient Coordinators: signaterapc@natera.com| Phone: 650.489.9050| Fax: 650.412.1962

Altera™ : Supporting Informed Treatment Decisions

The Altera™ test is designed to give physicians and patients clinically actionable information to help support informed treatment decisions and strategies. With detailed, personalized genomic data, including insights into treatment resistance, Altera™ empowers clinicians and patients to navigate treatment paths together with more confidence.

Comprehensive Insights for Treatment Planning
The Altera™ tumor genomic profile is a test that looks for specific genetic changes in your tumor. This information, along with your personal cancer history, can help you and your doctor make decisions about your treatment plan.
Your test results will include the sections below. Make sure to go over these results with your doctor.
Tumor Genomic Alterations

This tells you about any genetic changes found in your tumor that might be linked to FDA-approved cancer treatments or clinical trials. These changes are called genomic alterations or genomic targets.
Genomic Alterations Detail
Drug Evidence Detail
Clinical Trials Report
Variant of Uncertain Significance (VUS)
Test Not Performed (TNP)
Your doctor will look at your test results along with your medical and cancer history to figure out the best next steps for your treatment.

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Why Tumor Profiling?

If you have been diagnosed with a solid tumor cancer, you and your doctor may want to explore treatment options available to you. Tumor genomic profiling can be used as a tool to identify what treatments may be more effective for your specific tumor. Additionally, it can be used to find clinical trial options that may be available based on your tumor’s genetic characteristics.

How will knowing my tumor genomic profile impact my treatment?

Whether you’re starting an initial treatment plan or considering alternative options, Altera is a specialized test designed to analyze your tumor’s genetic makeup. This analysis ensures that any potential treatment or clinical trial options are thoroughly reviewed and reported to you. By examining the genetic composition of your cancer, Altera identifies changes that provide deeper insights into your cancer biology, helping to customize your treatment approach effectively.

My doctor ordered Altera™. What’s Next?

Altera™ is a tumor genomic profile test that uses a small piece of tumor tissue to look at cancer cells to determine if was caused by certain genetic changes .
This information, along with your personal cancer history, can help your doctor make more informed decisions about your personal treatment plan.
Once testing is completed, your doctor will receive the test results and will discuss the next steps with you.
The test result typically take about 3-4 weeks to come back.

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One Sample, Two Important Tests

With just one small piece of your tumor or biopsy, your doctor can order two tests that can provide valuable information:

Altera™: This helps your doctor choose the best treatment for you.
Signatera™: This helps your doctor monitor how well your treatment is working and if your cancer might come back.

Here’s why it’s beneficial for you:

Your doctor can order both tests together, so another tumor sample is not required.
It allows your doctor to keep track of your progress over time.
Your doctor will take care of ordering the tests and explaining the results to you.
Natera is committed to making the testing experience as stress-free as possible.

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