Fig. 5. Polyclonal resistance to neratinib.
A patient with adenosquamous carcinoma of the gallbladder harbouring a HER2 amplified/S310F mutation who had progression of disease on gemcitabine plus cisplatin, FOLFOX, and FOLFIRI achieved a confirmed PR on treatment with neratinib. a Cross-sectional and treatment course imaging showing tumour response and progression (purple arrow); b serial cfDNA and c paired paired-tissue next-generation sequencing. cfDNA cell-free DNA, EOT end of treatment, FOLFIRI 5-fluorouracil/folinic acid + irinotecan, FOLFOX 5-fluorouracil/folinic acid + oxaliplatin, MSK-ACCESS Memorial Sloan Kettering-Analysis of Circulating cfDNA to Evaluate Somatic Status, MSK-IMPACT Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets, PR partial response, tx treatment. Source data are provided as a Source Data file.