Fig. 7: Tumor agnostic ctDNA methylation profiling reveals concordant tumor fraction changes to mutation based ctDNA approach.

Comparison of ctDNA derived tumor burden over course of therapy in index cases ID9 A and ID15 B using average mutation allele frequency (MAF) derived from ctDNA based MRD assay (black), and ctDNA based tumor agonistic methylation panel using differential methylation fragment burden (DMFs, red) shows similar dynamics and confirms molecular ctDNA progression precedes radiographic progression. C Heatmap of changes in signal over 2396 cancer associated methylation regions over the course of therapy with re-emergence of signal starting cycle 16 of chemotherapy in ID15. D Fifteen loci known to be hypermethylated in gastric cancer showing high methylation signature in ctDNA at baseline and changes of response and re-emergence around cycle 16 in ID15.