PMC6121109_01
Treatment course (Bev, bevacizumab; Iri, irinotecan; PMAb, panitumumab; LN, lymph node; Tissue NGS, tissue next generation sequencing; Guardant360, cell free DNA profiling; Cabo, cabozantinib).
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F1
A 57-year-old male was initially diagnosed with locally advanced rectal cancer (T3N1M0) and treated with neoadjuvant chemoradiation followed by surgical resection (Figure 1).
Chest CT image (A) before the start of cabozantinib plus panitumumab and (B) after 42 days of cabozantinib plus panitumumab.
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F2
After ~6 weeks of treatment, CT demonstrated dramatic improvement in his pulmonary tumor burden (see Figure 2), as well as resolution of dyspnea and cough.
Pre and Post treatment cfDNA profile of (A) mutant allele frequency (MAF) and (B) copy number variation (CNV).
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F3
CfDNA profiling performed after 28 days of treatment revealed loss of MET and EGFR amplification (Figure 3A), while the mutant allele frequency (MAF) of KRAS G13D increased from 0.3 to 0.6%. There was also a nearly 10-fold decrease in the MAF of TP53 R213* post treatment, likely correlating with the dramatic reduction of tumor burden (Figure 3B).