228

---

Click the image below to view the full size version of this cover.

Issue 228: In the CHRONOS clinical trial we integrated liquid biopsy for circulating tumor DNA (ctDNA) detection into real-time therapeutic decision-making for metastatic colorectal cancer. In this artwork it is metaphorically expressed how, with the passage of time, the mutational state of the tumor can change through a process of Darwinian evolution taking place under the pharmacological pressure of the therapies previously received by the patient. It is therefore essential to understand this clock of tumor evolution and liquid biopsy, by evaluating shedding of tumor DNA molecules in the blood. This allows to timely assess the genetic make-up of the tumor at the actual moment of starting a targeted treatment and allows to achieve best outcomes.