case_images: PMC6754891_01
case_images: ctDNA analysis detects disease recurrence in a breast cancer patient five months before clinical recurrence. Levels of the tumor markers CA-153 and carcinoembryonic antigen (CEA) are displayed. The detection of ctDNA mutations and liver metastases, as well as the initiation of everolimus therapy, is indicated by red arrows.
case_images: CRIONM2019-6545298.001.jpg
case_images: PMC6754891_01_CRIONM2019-6545298.001.jpg
case_images: fig1
case_images: September 2016, a CT scan indeed revealed multiple liver metastases, and tumor markers were found to be elevated in the blood (Figure 1). Since the detection of the PIK3CA mutation indicated an activation of the mTOR pathway, the patient was treated with an oral dose of 10 mg everolimus daily. Upon everolimus therapy, there was a decrease of tumor markers CEA and CA-153 in the blood (Figure 1).
case_images: Shrinkage of liver metastasis upon everolimus therapy. A liver CT image is shown for September 2016 displaying a liver lesion for which the location is indicated by a yellow arrow and the diameter marked by a blue dotted line (a). Since the detection of the PIK3CA N345K variant indicated an activation of the mTOR pathway, everolimus therapy was initiated. Marked shrinkage of liver metastases was observed by a follow-up CT scan three months after targeted treatment initiation (b).
case_images: CRIONM2019-6545298.002.jpg
case_images: PMC6754891_01_CRIONM2019-6545298.002.jpg
case_images: fig2
case_images: Liver metastasis showed remarkable shrinkage after three months of treatment (Figure 2).