PMC10332633_01
Representative computed tomography (CT) images of liver lesions during -firstline mFOLFOX6+cetuximab treatment.
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A deep and long-lasting PR, with a response duration of 16 months, was obtained ( Figure 1 ).
Representative computed tomography (CT) images of liver lesions during anti-EGFR antibody rechallenge treatment (sixth-line, CPT-11+cetuximab). Yellow arrows indicate liver metastases.
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The best response to anti-EGFR rechallenge therapy was PR ( Figure 2 ).
Schematic representation of the dynamics of RAS-altered clones monitored through circulating tumor DNA from the patient. Each treatment received by the patient is indicated on the graph. Blue bars represent variation of tumor load, compared to baseline, during treatments as specified above the graphs. Tumor load was calculated as percentage change based on measurable disease at initiation of treatment (baseline), set as 100%. The dotted red line indicates the changes in carcinoembryonic antigen (CEA) values (ng/ml). The solid lines show the course of the frequency of each RAS mutation (percentage of alleles) detected in circulating DNA at the indicated time points. Each RAS mutation is indicated by a differently colored solid line. CET, cetuximab; RAM, ramucirumab; TAS, tipiracil hydrochloride; BEV, bevacizumab; CAPOX, capecitabine and oxaliplatin; Cape,capecitabine; FOLFIRI, folinic acid, 5-fluorouracil and CPT-11; mFOLFOX, folinic acid, fluorouracil and oxaliplatin; F-1 Liquid, FoundationOne  Liquid CDx.
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A schematic representation of the patient's clinical history is shown in  Figure 3 .