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Furthermore, these mutation-bearing cells were expanded in number at the time of relapse (Supplementary Fig. 4A).
A standard treatment is cytoreductive surgery followed by adjuvant chemotherapy, and re-treatment with platinum based chemotherapy at the time of relapse.
From Patient 4, only one sample at the time of relapse was available, and hence it was not possible to follow changes in the clonal dynamics in this patient.
Nonetheless, in this patient, the previously reported BTK-C481S mutation was detected by WES, by deep sequencing at the time of relapse and by RNA-sequencing (RNA-seq) of the same sample (Supplementary Fig. 3A).
The mean dose at time of relapse was 888 mg/day.
Patients on the observation arm of therapy were offered salvage HDC at the time of relapse.
The patient also recorded the use of medication, the possible relapse including time of relapse, and any possible adverse event.
We also calculate the time of relapse if applicable.
The median time of relapse after treatment was six months.
However, these mutations generally occur at the time of relapse.
Treatment at the time of relapse depended on a number of factors.
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