{"entity":{"id":"altera","kind":"drug","name":"Altera","aka":["Natera Altera"],"tldr":"Natera's tumour gene test, which reads every gene's DNA and RNA and can be ordered on the same sample as its Signatera blood test for recurrence.","summary":"Altera is Natera's comprehensive genomic profiling test. Whole-exome DNA sequencing across about 20,000 genes reports single-nucleotide variants, insertions and deletions, copy number changes and selected rearrangements, with microsatellite instability and tumour mutational burden; whole-transcriptome RNA sequencing adds fusions and transcripts such as AR-V7, EGFR vIII and MET exon 14 skipping; and PD-L1 (22C3) and HER2 immunohistochemistry are included automatically. One tumour sample can be used for both Altera and Signatera, Natera's residual disease blood test. Natera states that its tests were developed by its CLIA-certified laboratory and have not been cleared or approved by the FDA.","status":"established","asOf":"2026-11-03","links":[{"label":"Natera: Altera comprehensive genomic profiling","url":"https://www.natera.com/oncology/altera/"}],"tags":["test"],"related":["signatera","msi-high","tmb-high"],"cancers":[],"sections":[],"technologies":["wes-wgs","cgp","rna-seq"],"targets":[],"drugs":[],"companies":["natera"],"institutions":[],"pathways":[],"terms":["ngs","tmb","msi","ihc","ar-v7"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["What a result means: the report lists alterations linked to approved drugs, immunotherapy and trials; ordering it with Signatera saves a second request for tumour tissue."],"brand":"Altera","modality":"Tumour profiling test (whole exome, whole transcriptome and immunohistochemistry)","mechanism":"Whole-exome DNA sequencing of about 20,000 genes and whole-transcriptome RNA sequencing of the tumour, with PD-L1 (22C3) and HER2 immunohistochemistry included automatically.","approvals":[],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/altera/","neighbours":{"drug":[{"id":"signatera","kind":"drug","name":"Signatera","route":"/drugs/signatera/"}],"biomarker":[{"id":"msi-high","kind":"biomarker","name":"MSI-high (microsatellite instability by PCR or sequencing)","route":"/biomarkers/msi-high/"},{"id":"tmb-high","kind":"biomarker","name":"TMB-high (tumour mutational burden >= 10 mutations per megabase)","route":"/biomarkers/tmb-high/"}],"technology":[{"id":"cgp","kind":"technology","name":"Comprehensive genomic profiling","route":"/technologies/cgp/"},{"id":"rna-seq","kind":"technology","name":"RNA sequencing & expression profiling","route":"/technologies/rna-seq/"},{"id":"wes-wgs","kind":"technology","name":"Whole-exome & whole-genome sequencing","route":"/technologies/wes-wgs/"}],"company":[{"id":"natera","kind":"company","name":"Natera","route":"/companies/natera/"}],"term":[{"id":"ar-v7","kind":"term","name":"AR-V7 splice variant","route":"/terms/ar-v7/"},{"id":"ihc","kind":"term","name":"Immunohistochemistry (IHC)","route":"/terms/ihc/"},{"id":"msi","kind":"term","name":"Microsatellite instability (MSI-H) / mismatch repair deficiency (dMMR)","route":"/terms/msi/"},{"id":"ngs","kind":"term","name":"Next-generation sequencing (NGS)","route":"/terms/ngs/"},{"id":"tmb","kind":"term","name":"Tumour mutational burden (TMB)","route":"/terms/tmb/"}]}}