Natera Announces New Data From Two Studies Extending the Clinical Validation of Its Prospera™ Heart dd-cfDNA Test for Heart Transplant Recipients
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Insights
The recent studies on the Prospera Heart test represent a significant advancement in the field of organ transplantation, particularly concerning the non-invasive detection of heart transplant rejection. The high area under the curve (AUC) values reported in these studies indicate a strong ability of the test to distinguish between rejection and non-rejection cases. The AUC is a measure of a test's accuracy, with a value of 1.0 representing perfect accuracy. In medical diagnostics, an AUC of over 0.8 is generally considered excellent and the Prospera Heart test's AUCs of 0.82 to 0.90 in different patient cohorts suggest a high level of reliability.
Moreover, the negative predictive value (NPV) is another critical measure, indicating the likelihood that patients with a negative test result truly do not have the condition. The reported NPVs of 92% to 99% are particularly noteworthy because they suggest that the Prospera Heart test can reliably rule out rejection, potentially reducing the need for invasive endomyocardial biopsies (EMBs). This could lead to a paradigm shift in post-transplant care, emphasizing patient comfort and cost savings from fewer invasive procedures.
From an economic perspective, the integration of the Prospera Heart test into standard patient care could have substantial financial implications for the healthcare system. By potentially reducing the frequency of invasive biopsies, there are direct cost savings associated with the procedure itself, as well as indirect savings from the reduced need for hospitalization and the associated care. Furthermore, increased patient throughput without the need for recovery from biopsy procedures could improve the efficiency of transplant centers.
Long-term, the adoption of non-invasive tests like Prospera could lead to a decrease in overall treatment costs for heart transplant recipients. However, it is essential to consider the cost of the test itself and whether it will be widely covered by insurance providers, including Medicare. The balance between the test's price and the cost savings from avoided biopsies will be a important factor in its adoption.
For investors and stakeholders in Natera Inc., the publication of these studies and the performance metrics of the Prospera Heart test could be a positive indicator of the company's potential growth in the organ transplant diagnostics market. The test's Medicare coverage following the DEDUCE study is a strong endorsement, as reimbursement by insurance is often a significant hurdle for new medical technologies.
The stock market typically reacts to such developments based on their potential to generate revenue. If the Prospera Heart test is adopted as a standard of care, it could lead to increased sales for Natera. However, it is important to monitor the competitive landscape, as other companies may also be developing similar non-invasive tests. Additionally, the actual market penetration and utilization rates post-adoption will be key factors in determining the financial impact on Natera's bottom line.
Prospective, multi-center Trifecta-Heart and DTRT-2 studies demonstrate excellent performance of the Prospera Heart test for detecting rejection in adults and pediatrics
“We are encouraged by the results of these two prospective studies,” said Sangeeta Bhorade, MD, chief medical officer of organ health at Natera. “The consistent, excellent performance of Prospera Heart across multiple independent studies should inspire confidence among transplant physicians to leverage Prospera as part of standard patient care.”
The Prospera Heart test was launched in 2021 and received Medicare coverage following the 2022 publication of a multi-site clinical validation study, the DEDUCE study, in the Journal of Heart and Lung Transplantation. That study showed the Prospera Heart test had an overall area under the curve (AUC) of 0.86 for identifying acute rejection in over 800 samples from 200 adults with heart transplants.
The DTRT-2 (DNA-Based Transplant Rejection Test) study, published recently in Pediatric Transplantation, was sponsored by the National Institutes of Health (NIH). A total of 487 samples from 160 heart transplant recipients were evaluated, of which 78 were pediatric and 82 were adult patients. The Prospera Heart test demonstrated outstanding performance in detecting rejection, as determined by histopathology from endomyocardial biopsies (EMBs), with an AUC of 0.82 in adult patients and 0.83 in pediatric patients. The study reported a negative predictive value (NPV) of
“DTRT-2 is a landmark study that further demonstrates that the Prospera Heart test is a highly reliable, non-invasive tool for detecting heart transplant rejection in adult patients, and now solidifies that outstanding performance for pediatric patients as well,” said Shriprasad R. Deshpande, MBBS, MS, director of the Advanced Cardiac on Therapies and Heart Transplant Program, Children’s National Hospital, and lead author of the study. “Based on these findings, I believe the Prospera Heart test has the potential to greatly reduce the number of invasive surveillance biopsies in children and enhance their quality of life.”
The Trifecta-Heart study had its initial publication last week in Transplantation and has an upcoming oral presentation at the 2024 International Society for Heart and Lung Transplantation (ISHLT) Annual Meeting. This initial readout included 137 plasma samples analyzed using the Prospera Heart test, correlated with matched EMBs analyzed using the Molecular Microscope® Diagnostic System (MMDx), a more objective reference standard for rejection compared to histopathology. Based on data collected in the first 18 months, the Prospera Heart test was highly accurate in distinguishing acute rejection from non-rejection, with an AUC of 0.90 and a NPV of
Roughly 4,100 heart transplants are performed each year in the
These latest data come just before the 2024 ISHLT Annual Meeting, where Natera will deliver one oral presentation and six poster presentations related to its Prospera Heart and Prospera Lung tests.
About the Prospera test
The ProsperaTM test leverages Natera’s core single-nucleotide (SNP)-based massively multiplexed PCR (mmPCR) technology to identify allograft rejection non-invasively and with high precision and accuracy, without the need for prior donor or recipient genotyping. The test works by measuring the fraction of donor-derived cell-free DNA (dd-cfDNA) in the recipient’s blood. It may be used by physicians considering the diagnosis of active rejection, helping to rule in or out this condition when evaluating the need for diagnostic testing or the results of an invasive biopsy. The Prospera test has been clinically and analytically validated for performance regardless of donor relatedness, rejection type, and clinical presentation.
About Natera
NateraTM is a global leader in cell-free DNA testing, dedicated to oncology, women’s health, and organ health. We aim to make personalized genetic testing and diagnostics part of the standard of care to protect health, and inform earlier, more targeted interventions that help lead to longer, healthier lives. Natera’s tests are validated by more than 180 peer-reviewed publications that demonstrate high accuracy. Natera operates ISO 13485-certified and CAP-accredited laboratories certified under the Clinical Laboratory Improvement Amendments (CLIA) in
Forward-Looking Statements
All statements other than statements of historical facts contained in this press release are forward-looking statements and are not a representation that Natera’s plans, estimates, or expectations will be achieved. These forward-looking statements represent Natera’s expectations as of the date of this press release, and Natera disclaims any obligation to update the forward-looking statements. These forward-looking statements are subject to known and unknown risks and uncertainties that may cause actual results to differ materially, including with respect to whether the results of clinical or other studies will support the use of our product offerings, the impact of results of such studies, or our expectations of the benefits of our tests and product offerings to patients, providers and payers. Additional risks and uncertainties are discussed in greater detail in "Risk Factors" in Natera’s recent filings on Forms 10-K and 10-Q and in other filings Natera makes with the SEC from time to time. These documents are available at www.natera.com/investors and www.sec.gov.
References
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Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR). OPTN/SRTR 2022 Annual Data Report: Heart.
U.S. Department of Health and Human Services, Health Resources and Services Administration. 2024. Accessed April 4, 2024. https://srtr.transplant.hrsa.gov/annual_reports/2022/Heart.aspx#fig:HRtx-adult-counts-all - Bermpeis K, Esposito G, Gallinoro E, et al. Safety of right and left ventricular endomyocardial biopsy in heart transplantation and cardio-myopathy patients. JACC Heart Fail. 2022;10:963–973.
- Strecker T, Rösch J, Weyand M, et al. Endomyocardial biopsy for monitoring heart transplant patients: 11-years-experience at a German heart center. Int J Clin Exp Pathol. 2013;6:55–65.
- Deckers JW, Hare JM, Baughman KL. Complications of transvenous right ventricular endomyocardial biopsy in adult patients with cardio-myopathy: a seven-year survey of 546 consecutive diagnostic procedures in a tertiary referral center. J Am Coll Cardiol. 1992;19:43–47.
- Hamour IM, Burke MM, Bell AD, et al. Limited utility of endomyocardial biopsy in the first year after heart transplantation. Transplantation. 2008;85:969–974.
- Hull JV, Padkins MR, Hajj SE, et al. Risks of right heart catheterization and right ventricular biopsy: a 12-year, single-center experience. Mayo Clin Proc. 2023;98:419–431.
- Cusi V, Vaida F, Wettersten N, et al. Incidence of Acute Rejection Compared With Endomyocardial Biopsy Complications for Heart Transplant Patients in the Contemporary Era. Transplantation. 2023. Epub ahead of print. PMID: 38098137.
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Investor Relations: Mike Brophy, CFO, Natera, Inc., 510-826-2350, investor@natera.com
Media: Lesley Bogdanow, VP of Corporate Communications, Natera, Inc., pr@natera.com
Source: Natera, Inc.
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