Fig. 6: Prevalence and dynamics of putative resistance alterations in longitudinal ctDNA analysis. | Nature Communications

Fig. 6: Prevalence and dynamics of putative resistance alterations in longitudinal ctDNA analysis.

From: Clinical outcomes and ctDNA correlates for CAPOX BETR: a phase II trial of capecitabine, oxaliplatin, bevacizumab, trastuzumab in previously untreated advanced HER2+ gastroesophageal adenocarcinoma

Fig. 6

A Comparison of ctDNA NGS profiles from diagnosis and at the time of progression on therapy in 19 cases are shown. 10 cases show evidence of novel alterations (orange boxes) including in several putative resistance alleles such as KRAS, NRAS, PIK3CA, and PTEN. Interestingly, Pt 9 shows evidence of multiple new ERBB2 alterations. B Longitudinal monitoring of dynamics of resistance (red) and truncal alleles (black) in select four cases using ultra-deep sequencing for higher sensitivity. In general, low level resistance alleles are identified at diagnosis, are effective suppressed with therapy re-emerging several cycles prior to radiographic progression.

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