Establishment of 12 PDX from BRAF inhibitor–progressed patients.

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Establishment of 12 PDX from BRAF inhibitor–progressed patients. Establishment of 12 PDX from BRAF inhibitor–progressed patients. A, schematic of BRAF inhibitor–resistant PDX generation, expansion, characterization, and in vivo testing. The arrow shown in blue outline denotes possible future clinical translation. B, PFS of patients is measured from first day on drug (vemurafenib/solid bar or dabrafenib/hatched bar) to progression by RECIST. Best response is denoted by the color of each bar: stable disease, light blue; partial response, blue; surgical complete response, green. Each bar represents one patient, 1/2 denote two samples collected from the same patient. C, PDX tumor grafts are followed from implantation until palpable; blue bars are untreated mice; and red bars are mice continuously dosed with BRAF inhibitor (PLX4720) diet. Mean of mouse cohorts (n > 5) is shown; error bars are SEM. D, growth rate of the same tumor grafts from palpable until sacrifice is calculated by maximum tumor volume in mm3/time in weeks, thus higher values indicate a faster growth rate; blue bars are untreated mice; and red bars are mice continuously dosed with BRAF inhibitor (BRAFi; PLX4720) diet. Mean of mouse cohorts (n > 5) is shown; error bars are SEM. E, histologic examination of patient tumor tissue used to generate the PDX and subsequent PDX passages harvested; WM3965-2 is shown as a representative model, all others are shown in Supplementary Fig. S2; MP1, first mouse passage; MP4, 4th serial transplantation in mice; on BRAFi, Rel., relative; mice were continuously dosed with BRAF inhibitor diet; H&E staining except PDX S100, a melanoma marker. Clemens Krepler et al. Clin Cancer Res 2016;22:1592-1602 ©2016 by American Association for Cancer Research