FIG. 5.

Longitudinal evaluation showing that circulating hybrid cells (CHCs) decrease during neoadjuvant therapy (NAT) for rectal adenocarcinoma. a Patient 1 had clinical stage 3 rectal cancer treated with total neoadjuvant therapy (TNT) and rectal MRI demonstrating a near-complete clinical response (cCR). The CHC levels decreased 67% with the initiation of chemoradiotherapy (CXRT). At the end of leucovorin-fluorouracil-oxaliplatin (FOLFOX) chemotherapy, the CHCs were 95% of their pre-therapy levels. The carcinoembryonic antigen (CEA) level had no clinically relevant changes with NAT. b Patient 2 had clinical stage 3 rectal cancer that demonstrated findings of a cCR by endoscopy. The CHC level decreased with CXRT and two FOLFOX cycles but remained stable at the end of NAT. The CEA levels were not associated with treatment response.