Figure 3.

Timeline of patient clinical history, testing, and results. Schematic demonstrating the patient's overall presentation and clinical course highlighted with both traditional and precision medicine–directed molecular results. The patient developed a whole-body rash of unexplained origin that was resistant to multiple topical and systemic treatments 3 mo prior to her diagnosis of ovarian cancer. The original rash disappeared within days of tumor debulking at the time of primary surgery and initiation of chemotherapy. The rash reappeared ∼1 yr later and suggested the possibility of cancer recurrence. Results of serum CA125 levels, CT and PET scans, and ultrasound (US) throughout her care are shown. The patient's tumor was sequenced at the timepoint shown (green arrowhead), with the express intent to identify somatic mutations and develop patient-specific ctDNA biomarkers. These tumor-specific mutations were simultaneously screened for in blood samples, second-look biopsies, and a pelvic wash sample (purple), all of which had been previously collected in real time and biobanked. In the upper and lower panels, the clinical presentation, surgical history, and chemotherapy events are shown as well as the clinical and molecular results including both next-generation sequencing (NGS) and droplet digital polymerase chain reaction (ddPCR) assay results, respectively. Results are shown as positive (+) or negative (−).