The Phase III IMvigor011 trial used Natera’s tumor‑informed Signatera test to select muscle‑invasive bladder cancer patients for adjuvant atezolizumab and reported a clinically meaningful survival benefit for Signatera‑positive patients receiving treatment. The randomized data represent one of the strongest validations to date for circulating tumor DNA (ctDNA)‑guided therapy and strengthen the case for MRD assays as companion diagnostics. Natera said it is finalizing a premarket application to the FDA for Signatera as a companion diagnostic for Tecentriq, a move that would accelerate clinical adoption and reimbursement discussions. Industry analysts flagged the trial as a potential turning point for MRD‑driven decision‑making across solid tumors.