Natera announced statistically significant improvement in disease-free and overall survival for Signatera-positive patients receiving Genentech’s Tecentriq in the Phase III IMvigor011 trial for muscle-invasive bladder cancer. Signatera, a circulating tumor DNA test detecting minimal residual disease, serves as a companion diagnostic to guide adjuvant treatment decisions. The trial enrolled approximately 760 patients post-cystectomy. Positive findings support a novel treatment paradigm targeting molecular recurrence rather than radiographic disease and could lead to FDA approval of Signatera for patient selection.