Fig. 2: Drug-driven evolution of RET-mutant metastatic MTC.
From: Adaptive Darwinian off-target resistance mechanisms to selective RET inhibition in RET driven cancer
a Patient’s calcitonin levels, variant allele frequency (VAF) of the RET p.D898_E901del mutation in cfDNA assay, the time points when genetic alterations were identified in samples from tissue biopsy (red arrows) or lipid biopsy (black arrows), and the treatment history. Red circle points of calcitonin were those in the normal range. b Contrast-enhanced computed tomography (CT) imaging of the abdomen over time: a, baseline scan shows innumerable hepatic metastases; b, first follow-up scan shows significant positive response to therapy with decrease in size and enhancement of multiple lesions; c, CT shows appearance of a tiny new lesion (arrow). d–f, the lesion continues to enlarge on subsequent scans and was first noted on e and progression confirmed on f.
