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Fig. 3 | Journal of Hematology & Oncology

Fig. 3

From: Clinical utility of tumor genomic profiling in patients with high plasma circulating tumor DNA burden or metabolically active tumors

Fig. 3

MSAF is a valid tool for quantifying the tumor fraction of cfDNA. A representative case showing MSAF was a better tool than cfDNA and SUVmax to correlate with clinical response when the patient had non-infectious, immune-related pneumonitis. A Schema of the clinical course. B Radiographic evaluation: a 67-year-old Caucasian male, former four pack-year smoking history (quit 20 years ago), presented with refractory, lung squamous cell carcinoma (i). The patient developed non-productive cough and shortness of breath after three doses of nivolumab monotherapy and was found to have biopsy-proven, new tumor formation in right lower lobe as well as grade 3 pneumonitis in bilateral lung fields (ii) [46]. However, notable tumor shrinkage at several pre-existing tumors was observed. Blood drawn at 10 weeks later before the initiation of high dose steroids revealed non-detectable ctDNA (i.e., MSAF zero) (iii). Despite discontinuation of nivolumab and use of steroids for over 2 months for symptomatic pneumonitis, continued tumor response to a complete remission was evident by radiographic assessment by ~ 3 months (iv), which has been maintained at 9 months (v) and a recent 3-year follow-up (data not shown). C Quantitative analysis of biomarkers and clinical responses were summarized in table

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