Figure 2:
Tumor and cell-free DNA sequencing at diagnosis and after progression on combination dabrafenib and trametinib shows acquisition of an NRAS Q61K mutation
A. Aligned sequencing reads from a pre-treatment tumor biopsy (top) detected a BRAF c. 1799T>A point mutation (p.V600E); sequencing of a repeat biopsy after progression on combination dabrafenib and trametinib (bottom) demonstrated persistence of the BRAF 1799T>A mutation and the acquisition of a NRAS c.181C>A point mutation (p.Q61K).
B. Commercial plasma genotyping also detected BRAF V600E in both pre-treatment and post-treatment samples, but NRAS Q61K was only detected after progression on combination dabrafenib and trametinib.s
