NTRA: NCCN Bladder Guidelines Updated to Include Signatera CDx for Tecentriq in Adjuvant MIBC

Research evidence excerpt

NTRA: NCCN Bladder Guidelines Updated to Include Signatera CDx for Tecentriq in Adjuvant MIBC

FLASH NOTE

June 22, 2026

Subbu Nambi, Ph.D. subbu.nambi@guggenheimpartners.com NTRA: NCCN Bladder Guidelines Updated to Include

617 874 7383 Signatera CDx for Tecentriq in Adjuvant MIBC

Ricki Levitus

ricki.levitus@guggenheimpartners.com

212 823 6556 Key Message: Today, NCCN released Version 2.2026 of its bladder cancer treatment

guidelines, which are updated to include a category 1 recommendation to test patients Thomas VonDerVellen

thomas.vondervellen@guggenheimpartners.com with Signatera after cystectomy and to treat with Tecentriq if MRD positive. While this

617 859 4657 update was largely expected following the FDA approval of Tecentriq & Signatera CDx,

it can be a meaningful driver of Signatera volumes and clinical ASPs in 2H26.

& MIBC Background

NTRA IMvigor011 IMvigor011 is a randomized phase III study evaluating the Trial Design: • IMvigor011 Natera, Inc. efficacy of atezolizumab (commercial name Tecentriq, RHHBY) as an adjuvant treatment Sector: Diagnostics & Life Sciences Tools in patients with high-risk muscle invasive bladder cancer (MIBC) who are positive for

Company Update ctDNA post surgery (cystectomy). The study uses NTRA's Signatera for evaluating ctDNA status as an enrollment criterion for patients. See the full study background and results

Share Price $231.41 presented at EAU 2024 in our note here. In mid-August 2025, NTRA announced that the

top line results from IMvigor011 showed a disease-free survival benefit when patients

were treated based on Signatera test status (see our note here). Market Data

IMvigor011 results were then presented at ESMO 2025. A total of 52-Week Range $131.81 - $256.36 • IMvigor011 Results: