Figure 1. Acquired resistance to KRAS^G12C inhibitor MRTX849 (adagrasib).

A, Computed tomography (CT) images of the patient’s axillary lymph node metastasis at baseline, during response to MRTX849, and at progression on MRTX849. B, Variant allele fractions (VAFs) of mutations detected in the patient’s serial plasma samples. † indicates the mutations were detected by digital droplet PCR but not by plasma NGS. C, Alterations detected in post-MRTX849 cfDNA include acquired mutations in KRAS as well as multiple components of the MAPK signaling cascade. *KRAS^G12F represents a potential resistance mechanism supported by limited sequencing reads, as shown in Supplementary Figure S2.