Minimal residual disease (MRD) testing advanced toward clinical utility in 2025 after key randomized readouts and commercial consolidation, most notably the Phase III IMvigor011 trial. IMvigor011 used Natera’s Signatera tumor‑informed ctDNA assay to select muscle‑invasive bladder cancer patients for adjuvant immunotherapy with Genentech’s Tecentriq (atezolizumab) and showed statistically meaningful survival benefits for Signatera‑positive patients. Natera is preparing a premarket application to the US FDA seeking companion diagnostic status for Signatera, while analysts and clinicians flagged this as a pivotal solid‑tumor example of MRD guiding therapy. The year also saw acquisitions and payer/regulatory steps that could fast‑track broader MRD adoption across tumor types.