Follow up appointment with

oncologist (2-4 weeks post-op)

SampleCollectionSchedule

Treatment

Tissue

Blood

Initial Signatera testingComplete drawBegin

Signateratesting

Option 1

Follow recommendationsfor adjuvant treatmentresponse monitoring

Dignosis& biopsy Surgery Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8

Initiation ofadjuvant therapy

Recovery

Subsequent testing, draw withpre-treatment labs

Initial Signatera testing(pre-adjuvant treatment),

draw 2-4 weeks after surgery

Last draw for treatment response monitoring,followed by recurrence monitoring

2-4 weeks post-op

SampleCollectionSchedule

Treatment

Tissue

Blood

Dignosis& biopsy Surgery

Recommended blooddraw and testing frequency

Post-surgical monitoring for molecular residual disease (MRD)

Adjuvant—Treatment response monitoring

Adjuvant therapy Recurrence monitoring

Tissue

Blood

Initial Signatera testing

EDTA tube

Sample collection

Streck tubes

Tissue sample

Option 2

CONTINUED ON BACKCONTINUED ON BACK

Pre-treatmentLab 1

Pre-treatmentLab 2

Pre-treatmentLab 3

Pre-treatmentLab 4

Recommended blooddraw and testing frequency

Neoadjuvant—Treatment response monitoring

Recurrence monitoring after neoadjuvant therapy, surgery, or adjuvant therapy

Metastatic—Treatment response monitoring

Subsequent testing, draw withpre-treatment labs

Initial Signatera

testing

SampleCollectionSchedule

Treatment

Treatment

Tissue

Blood

Dignosis& biopsy

Initiation ofneoadjuvant therapy Surgery

Subsequent testing, draw withpre-treatment labs

Initial Signatera

testing

SampleCollectionSchedule

Tissue

Blood

Initialtimepoint

Every 3 months during �rst year after de�nitive treatment or remission

Every 6 months during second year of remission

Recurrence monitoring

Subsequent testing, draw withpre-treatment labs

Initial Signatera

testing

SampleCollectionSchedule

Tissue

Blood

Pre-treatmentlabs

Initiation ofmetastatic therapy Metastatic therapy

Completion ofde�nitive treatment

or remission

At the oncologist’s discretion:Draw at every cycle, or every three cycles

Blood sample collection instructions

1. Complete requisition form

• Select the appropriate Signatera screening option.

• Complete ALL appropriate �elds on the requisition form.

• Take one barcode sticker and af�x it to the requisition form. The remaining bar codes can be used for your paperwork.

• Fill two Streck tubes for all patients. An additional 6 mL EDTA is required for �rst time patients only.

• Fill all tubes completely. If insuf�cient volume is obtained, draw an additional tube.

• Allow 60–90 seconds for each tube to �ll.

• Use 21 gauge straight needle.

• Vein collapse may require second venipuncture with a fresh tube.

• Gently invert tube at least 8 times immediately after draw in order to thoroughly mix blood with reagents.

• Do NOT shake vigorously.

2. Collect blood sample

One 6mL EDTA tube AND two 10mL DNA Streck tubes

CONTINUED ON BACK

Do NOT store kits in an area where the temperature range is outside 18–30ºC or 65–86ºF.

65°F18°C

86°F30°C Do NOT expose

blood to temperatures outside the range of 43–98ºF or 6–37ºC.

43°F6°C

98°F37°C

Blood sample collection instructions

CONTINUED ON BACK

Blood sample collection instructions

CONTINUED ON BACKCONTINUED ON BACK

3. Pre-pack sample

A Complete information on tube labels.

B Place �lled and labeled tubes into the absorbant sleeve and into the metallic envelope. Place the metallic envelope into the biohazard bag.

This test was developed by Natera, Inc., a laboratory certi�ed under the Clinical Laboratory Improvement Amendments (CLIA). This test has not been cleared or approved by the US Food and Drug Administration (FDA). Although FDA does not currently clear or approve laboratory-developed tests in the US, certi�cation of the laboratory is required under CLIA to ensure the quality and validity of the tests. ©2019 Natera, Inc. All Rights Reserved.

MLB-10088_Rev01_SGN_Blood sample instructions_2019_07_31_NAT-801953

201 Industrial Road, Suite 410 | San Carlos, CA 94070 | www.natera.com | 1.650.489.9050 | Fax 1.650.412.1962

4. Shipping

A Pack blood sample, completed requisition form, copy of patient's insurance, and the cool pack included, into the Signatera Blood Collection Kit box.

B Place the kit box into the FedEx Clinical Pak envelope provided and af�x the prepaid shipping label. Call 1.800.GO.FEDEX to arrange a pickup.

+

Blood samplepacking and shipping

Conceive. Deliver. Thrive.

ClinicalPak