Change isn’t always for the best.
Cell-free DNA sequencing of cerebrospinal fluid from 14 patients before and after proton craniospinal irradiation (CSI) for leptomeningeal disease demonstrated the higher the variant allele frequency prior to CSI, the shorter the survival. Same went for after CSI. Interestingly, the appearance of new subclonal mutations after CSI also portended worse survival.
- Wijetunga, Clin Cancer Res 2022