77 research outputs found
The differentiated effects of CSR actions in the service industry
Purpose â The purpose of this study is to attempt to explain why the impact of Corporate Social Responsibility (CSR) initiatives may be different and/or more important in service firms compared to manufacturing firms. CSR is becoming a common strategy, hence its extensive research. Central to it is the analysis of the effect of CSR on a firmâs performance, whose outcome depends on firm-specific and industry-related factors. Design/methodology/approach â The event study methodology is applied to all the 248 companies that have ever traded on the Spanish Stock Market between 1990 and 2007. A regression analysis examines potential different effects of CSR on service and goods firms. Findings â The results show that CSR activities have a positive impact on firm performance that is higher for service firms than for manufacturing firms. Actions related to the environment, responsible labor relationships and good corporate governance are especially important in the service context. Research limitations/implications â This research is focused on shareholdersâ performance, but it does not consider other stakeholders, such as real consumer behavior or employeesâ commitment and productivity. Practical implications â Service firms are likely to gain from focusing on some CSR activities (environment, employees and good corporate governance) and should use their responsible behavior as a valuable tool for public relations and differentiation in the market. Originality/value â This article is the first attempt to empirically test and explain why the relationship between CSR and firm performance may be different (more positive) for service vs manufacturing firms.The authors would like to thank the Spanish Ministry of Science for financially supporting this research under Contract No. ECO2008-05487
Assessment of haemophilic arthropathy through balance analysis: a promising tool
This is an Author's Accepted Manuscript of an article published in Xavier GarcĂa-MassĂł, Yiyao Ye-Lin, Javier Garcia-Casado, Felipe Querol & Luis-Millan Gonzalez (2019) Assessment of haemophilic arthropathy through balance analysis: a promising tool, Computer Methods in Biomechanics and Biomedical Engineering, 22:4, 418-425, DOI: 10.1080/10255842.2018.1561877, available online at: http://doi.org/10.1080/10255842.2018.1561877.[EN] The purpose of this study was to develop a tool able to distinguish between subjects who have
haemophilic arthropathy in lower limbs and those who do not by analyzing the centre of pressure
displacement. The second objective was to assess the possible different responses of haemophiliacs and healthy subjects by creating a classifier that could distinguish between both groups. Fiftyfour haemophilic patients (28 with and 26 without arthropathy) and 23 healthy subjects took part
voluntarily in the study. A force plate was used to measure postural stability. A total of 276 centre
of pressure displacement parameters were calculated under different conditions: unipedal/bipedal
balance with eyes open/closed. These parameters were used to design a Quadratic Discriminant
Analysis classifier. The arthropathy versus non-arthropathy classifier had an overall accuracy of
97.5% when only 10 features were used in its design. Similarly, the haemophiliac versus nonhaemophiliac classifier had an overall accuracy of 97.2% when only 7 features were used. In conclusion, an objective haemophilic arthropathy in lower limbs evaluation system was developed by
analyzing centre of pressure displacement signals. The haemophiliac vs. non-haemophiliac classifier designed was also able to corroborate the existing differences in postural control between
haemophilic patients (with and without arthropathy) and healthy subjects.GarcĂa-MassĂł, X.; Ye Lin, Y.; Garcia-Casado, J.; Querol -Fuentes, F.; Gonzalez, L. (2019). Assessment of haemophilic arthropathy through balance analysis: a promising tool. Computer Methods in Biomechanics & Biomedical Engineering. 22(4):418-425. https://doi.org/10.1080/10255842.2018.1561877S418425224Amoud, H., Abadi, M., Hewson, D. J., Michel-Pellegrino, V., Doussot, M., & DuchĂȘne, J. (2007). Fractal time series analysis of postural stability in elderly and control subjects. Journal of NeuroEngineering and Rehabilitation, 4(1), 12. doi:10.1186/1743-0003-4-12AZNAR, J. A., ABAD-FRANCH, L., CORTINA, V. R., & MARCO, P. (2009). The national registry of haemophilia A and B in Spain: results from a census of patients. Haemophilia, 15(6), 1327-1330. doi:10.1111/j.1365-2516.2009.02101.xCabeza-Ruiz, R., GarcĂa-MassĂł, X., Centeno-Prada, R. A., Beas-JimĂ©nez, J. D., Colado, J. C., & GonzĂĄlez, L.-M. (2011). Time and frequency analysis of the static balance in young adults with Down syndrome. Gait & Posture, 33(1), 23-28. doi:10.1016/j.gaitpost.2010.09.014Cruz-Montecinos, C., De la Fuente, C., Rivera-Lillo, G., Morales-Castillo, S., Soto-Arellano, V., Querol, F., & PĂ©rez-Alenda, S. (2017). Sensory strategies of postural sway during quiet stance in patients with haemophilic arthropathy. Haemophilia, 23(5), e419-e426. doi:10.1111/hae.13297De SOUZA, F. M. B., PEREIRA, R. P., MINUQUE, N. P., Do CARMO, C. M., De MELLO, M. H. M., VILLAĂA, P., & TANAKA, C. (2012). Postural adjustment after an unexpected perturbation in children with haemophilia. Haemophilia, 18(3), e311-e315. doi:10.1111/j.1365-2516.2012.02768.xDORIA, A. S. (2010). State-of-the-art imaging techniques for the evaluation of haemophilic arthropathy: present and future. Haemophilia, 16, 107-114. doi:10.1111/j.1365-2516.2010.02307.xFALK, B., PORTAL, S., TIKTINSKY, R., WEINSTEIN, Y., CONSTANTINI, N., & MARTINOWITZ, U. (2000). Anaerobic power and muscle strength in young hemophilia patients. Medicine & Science in Sports & Exercise, 52. doi:10.1097/00005768-200001000-00009GALLACH, J. E., QUEROL, F., GONZĂLEZ, L. M., PARDO, A., & AZNAR, J. A. (2008). Posturographic analysis of balance control in patients with haemophilic arthropathy. Haemophilia, 14(2), 329-335. doi:10.1111/j.1365-2516.2007.01613.xGONZĂLEZ, L.-M., QUEROL, F., GALLACH, J. E., GOMIS, M., & AZNAR, V. A. (2007). Force fluctuations during the Maximum Isometric Voluntary Contraction of the quadriceps femoris in haemophilic patients. Haemophilia, 13(1), 65-70. doi:10.1111/j.1365-2516.2006.01354.xHACKER, M. R., FUNK, S. M., & MANCO-JOHNSON, M. J. (2007). The Colorado Haemophilia Paediatric Joint Physical Examination Scale: normal values and interrater reliability. Haemophilia, 13(1), 71-78. doi:10.1111/j.1365-2516.2006.01387.xHilberg, T., Herbsleb, M., Gabriel, H. H. W., Jeschke, D., & Schramm, W. (2001). Proprioception and isometric muscular strength in haemophilic subjects. Haemophilia, 7(6), 582-588. doi:10.1046/j.1365-2516.2001.00563.xHilgartner, M. W. (2002). Current treatment of hemophilic arthropathy. Current Opinion in Pediatrics, 14(1), 46-49. doi:10.1097/00008480-200202000-00008KHAN, U., BOGUE, C., UNGAR, W. J., HILLIARD, P., CARCAO, M., MOINEDDIN, R., & DORIA, A. S. (2009). Cost-effectiveness analysis of different imaging strategies for diagnosis of haemophilic arthropathy. Haemophilia, 16(2), 322-332. doi:10.1111/j.1365-2516.2009.02125.xKURZ, E., HERBSLEB, M., ANDERS, C., PUTA, C., VOLLANDT, R., CZEPA, D., ⊠HILBERG, T. (2011). SEMG activation patterns of thigh muscles during upright standing in haemophilic patients. Haemophilia, 17(4), 669-675. doi:10.1111/j.1365-2516.2010.02466.xLAFEBER, F. P. J. G., MIOSSEC, P., & VALENTINO, L. A. (2008). Physiopathology of haemophilic arthropathy. Haemophilia, 14(s4), 3-9. doi:10.1111/j.1365-2516.2008.01732.xLundin, B., Pettersson, H., & Ljung, R. (2004). A new magnetic resonance imaging scoring method for assessment of haemophilic arthropathy. Haemophilia, 10(4), 383-389. doi:10.1111/j.1365-2516.2004.00902.xMasui, T., Hasegawa, Y., Yamaguchi, J., Kanoh, T., Ishiguro, N., & Suzuki, S. (2006). Increasing postural sway in rural-community-dwelling elderly persons with knee osteoarthritis. Journal of Orthopaedic Science, 11(4), 353-358. doi:10.1007/s00776-006-1034-9Mitchell, S. L., Collin, J. J., De Luca, C. J., Burrows, A., & Lipsitz, L. A. (1995). Open-loop and closed-loop postural control mechanisms in Parkinsonâs disease: increased mediolateral activity during quiet standing. Neuroscience Letters, 197(2), 133-136. doi:10.1016/0304-3940(95)11924-lMolho, Rolland, Lebrun, Dirat, Courpied, ⊠Croughs. (2000). Epidemiological survey of the orthopaedic status of severe haemophilia A and B patients in France. Haemophilia, 6(1), 23-32. doi:10.1046/j.1365-2516.2000.00358.xPERGANTOU, H., MATSINOS, G., PAPADOPOULOS, A., PLATOKOUKI, H., & ARONIS, S. (2006). Comparative study of validity of clinical, X-ray and magnetic resonance imaging scores in evaluation and management of haemophilic arthropathy in children. Haemophilia, 12(3), 241-247. doi:10.1111/j.1365-2516.2006.01208.xPIPE, S. W., & VALENTINO, L. A. (2007). Optimizing outcomes for patients with severe haemophilia A. Haemophilia, 13(s4), 1-16. doi:10.1111/j.1365-2516.2007.01552.xPlug, I. (2004). Thirty years of hemophilia treatment in the Netherlands, 1972-2001. Blood, 104(12), 3494-3500. doi:10.1182/blood-2004-05-2008Prieto, T. E., Myklebust, J. B., Hoffmann, R. G., Lovett, E. G., & Myklebust, B. M. (1996). Measures of postural steadiness: differences between healthy young and elderly adults. IEEE Transactions on Biomedical Engineering, 43(9), 956-966. doi:10.1109/10.532130Leslie, R., & Catherine, M. (2007). Modern management of haemophilic arthropathy. British Journal of Haematology, 136(6), 777-787. doi:10.1111/j.1365-2141.2007.06490.xSILVA, M., LUCK, J. V., QUON, D., YOUNG, C. R., CHIN, D. M., EBRAMZADEH, E., & FONG, Y.-J. (2008). Inter- and intra-observer reliability of radiographic scores commonly used for the evaluation of haemophilic arthropathy. Haemophilia, 14(3), 504-512. doi:10.1111/j.1365-2516.2007.01630.xSouza, F. M. B., McLaughlin, P., Pereira, R. P., Minuque, N. P., Mello, M. H. M., Siqueira, C., ⊠Tanaka, C. (2013). The effects of repetitive haemarthrosis on postural balance in children with haemophilia. Haemophilia, 19(4), e212-e217. doi:10.1111/hae.12106TAKEDANI, H., FUJII, T., KOBAYASHI, Y., HAGA, N., TATSUNAMI, S., & FUJII, T. (2010). Inter-observer reliability of three different radiographic scores for adult haemophilia. Haemophilia, 17(1), 134-138. doi:10.1111/j.1365-2516.2010.02389.xTIKTINSKY, R., FALK, B., HEIM, M., & MARTINOVITZ, U. (2002). The effect of resistance training on the frequency of bleeding in haemophilia patients: a pilot study. Haemophilia, 8(1), 22-27. doi:10.1046/j.1365-2516.2002.00575.
Persistent HIV-controllers are more prone to spontaneously clear HCV: a retrospective cohort study.
HIV-controllers have the ability to spontaneously maintain viraemia at low or undetectable levels in the absence of antiretroviral treatment. Furthermore, HIV-controllers seem to have a superior capacity to spontaneously clear hepatitis C virus (HCV) compared to non HIV-controllers. Some of these subjects eventually lose HIV-controller status (transient controllers), whereas some HIV-controllers show a persistent natural HIV control (persistent controllers). We aimed to analyse whether persistent controllers have superior capacity to spontaneously clear HCV compared to transient controllers.
We recruited HIV-controllers from January 1981 up to October 2016 with available antibodies to HCV (anti-HCV) data (n = 744). Factors associated with HIV spontaneous control in relation to HCV status were analysed in persistent and transient HIV-controllers with anti-HCV positive (n = 202 and n = 138 respectively) in comparison with 1700 HCV positive non HIV-controllers recruited from January 1981 up to March 2018, bivariate and multivariate analyses, following a logistic regression model, were applied. In addition, the factors related to the loss and time to lose HIV-controller status were explored (n = 744) using Log rank test and Kaplan-Meier curves, in this case the multivariate analysis consisted in a Cox regression model.
A higher frequency of HCV spontaneous clearance was found in persistent HIV-controllers (25.5%) compared to non-controllers (10.2%). After adjusting for potential confounders, as sex, age, HIV transmission risk, CD4+ T-cell nadir and time of follow-up, HCV clearance was independently associated with persistent HIV spontaneous control (p = 0.002; OR (95% CI) = 2.573 (1.428 to 4.633)), but not with transient spontaneous control (p = 0.119; 1.589 (0.888 to 2.845)). Furthermore, persistent HIV-controllers were more likely to spontaneously clear the HCV in comparison with transient controllers (p = 0.027; 0.377 (0.159 to 0.893). Finally, not to lose or lengthen the time of losing this control was independently associated with HCV spontaneous clearance (p = 0.010; 0.503 (0.297 to 0.850).
This study shows an association between spontaneous persistent HIV-control and HCV spontaneous clearance. The study findings support the idea of preserved immune mechanisms in persistent HIV control implicated in HCV spontaneous clearance. These results highlight persistent HIV-controllers but not transient controllers as a good model of functional HIV cure.This work was supported by the Instituto de Salud Carlos III (research contracts CPII014/00025 to E.R.âM., and FI14/00431 to L.T.âD. and research projects PI12/02283, PI16/00684, PI19/01127 to E.R.âM.) and Red TemĂĄtica de InvestigaciĂłn Cooperativa en SIDA (Projects RD12/0017/0029, RD12/0017/0031, and RD16/0025/0020 and RD16/0025/0013), which is included in the AcciĂłn EstratĂ©gica en Salud, Plan Nacional de InvestigaciĂłn CientĂfica, Desarrollo e InnovaciĂłn TecnolĂłgica 2008 to 2011 and 2013 to 2016, Instituto de Salud Carlos III, Fondos FEDER. E.R.âM. was supported by ConsejerĂa de Salud y Bienestar Social of Junta de AndalucĂa through the NicolĂĄs Monardes program (Câ0032/17), N RallĂłn is a Miguel Servet investigator from the Spanish Carlos III Institute of Health (ISCIII), grant CP14/00198, Madrid, Spain and B.D.M. received a grant from The Spanish Ministry of Education (FPU13/02451). Work in CLâGâs laboratory was supported by grants SAF (2010 to 17226) and (2016â77894âR) from MINECO (Spain) and FIS (PI 13/02269, ISCIII) and in part by the RISâRETIC grants RD06/006/0036 and RD12/0017/0028 funded by the ISC IIIâFEDER. MP has a contract of RISâRETIC RD12/0017/0036.S
Prognostic Value of Serum Paraprotein Response Kinetics in Patients With Newly Diagnosed Multiple Myeloma
Response kinetics is not well-established as a prognostic marker in multiple myeloma (MM). We developed a mathematical model to assess the prognostic value of serum monoclonal component (MC) response kinetics during 6 induction cycles in 373 newly diagnosed MM patients. The model calculated a resistance parameter that reflects the stagnation in the response after an initial descent, dividing the patients into two kinetics categories with significantly different progression-free survival (PFS). Introduction: Response kinetics is a well-established prognostic marker in acute lymphoblastic leukemia. The situation is not clear in multiple myeloma (MM) despite having a biomarker for response monitoring (monoclonal component [MC]). Materials and Methods: We developed a mathematical model to assess the prognostic value of serum MC response kinetics during 6 induction cycles, in 373 NDMM transplanted patients treated in the GEM2012Menos65 clinical trial. The model calculated a resistance parameter that reflects the stagnation in the response after an initial descent. Results: Two patient subgroups were defined based on low and high resistance, that respectively captured sensitive and refractory kinetics, with progression-free survival (PFS) at 5 years of 72% and 59% (HR 0.64, 95% CI 0.44-0.93; P =.02). Resistance significantly correlated with depth of response measured after consolidation (80.9% CR and 68.4% minimal residual disease negativity in patients with sensitive vs. 31% and 20% in those with refractory kinetics). Furthermore, it modulated the impact of reaching CR after consolidation; thus, within CR patients those with refractory kinetics had significantly shorter PFS than those with sensitive kinetics (median 54 months vs. NR; P =.02). Minimal residual disease negativity abrogated this effect. Our study also questions the benefit of rapid responders compared to late responders (5-year PFS 59.7% vs. 76.5%, respectively [P <.002]). Of note, 85% of patients considered as late responders were classified as having sensitive kinetics. Conclusion: This semi-mechanistic modeling of M-component kinetics could be of great value to identify patients at risk of early treatment failure, who may benefit from early rescue intervention strategies. (C) 2022 The Authors. Published by Elsevier Inc
Safety and efficacy of asciminib treatment in chronic myeloid leukemia patients in real-life clinical practice
Results of an early access treatment protocol of daratumumab monotherapy in spanish patients with relapsed or refractory multiple myeloma
Daratumumab is a human CD38-targeted monoclonal antibody approved as monotherapy for heavily pretreated relapsed and
refractory multiple myeloma. We report findings for the Spanish cohort of an open-label treatment protocol that provided early access
to daratumumab monotherapy and collected safety and patient-reported outcomes data for patients with relapsed or refractory
multiple myeloma. At 15 centers across Spain, intravenous daratumumab (16mg/kg) was administered to 73 patients who had â„3
prior lines of therapy, including a proteasome inhibitor and an immunomodulatory drug, or who were double refractory to both. The
median duration of daratumumab treatment was 3.3 (range: 0.03â13.17) months, with a median number of 12 (range: 1â25)
infusions. Grade 3/4 treatment-emergent adverse events were reported in 74% of patients and included lymphopenia (28.8%),
thrombocytopenia (27.4%), neutropenia (21.9%), leukopenia (19.2%), and anemia (15.1%). Common (>5%) serious treatmentemergent adverse events included respiratory tract infection (9.6%), general physical health deterioration (6.8%), and back pain
(5.5%). Infusion-related reactions occurred in 45% of patients. The median change from baseline in all domains of the EQ-5D-5L and
EORTC QLQ-C30 was mostly 0. A total of 18 (24.7%) patients achieved a partial response or better, with 10 (13.7%) patients
achieving a very good partial response or better. Median progression-free survival was 3.98 months. The results of this early access
treatment protocol are consistent with previously reported trials of daratumumab monotherapy and confirm its safety and antitumoral
efficacy in Spanish patients with heavily treated relapsed or refractory multiple myeloma
Multiple myeloma and SARS-CoV-2 infection: clinical characteristics and prognostic factors of inpatient mortality
There is limited information on the characteristics, prognostic factors, and outcomes of patients with multiplemyeloma (MM) hospitalized with COVID-19. This retrospective case series investigated 167 patients reported from 73hospitals within the Spanish Myeloma Collaborative Group network in March and April, 2020. Outcomes werecompared with 167 randomly selected, contemporary, age-/sex-matched noncancer patients with COVID-19 admittedat six participating hospitals. Among MM and noncancer patients, median age was 71 years, and 57% of patients weremale; 75 and 77% of patients, respectively, had at least one comorbidity. COVID-19 clinical severity wasmoderate-severe in 77 and 89% of patients and critical in 8 and 4%, respectively. Supplemental oxygen was requiredby 47 and 55% of MM and noncancer patients, respectively, and 21%/9% vs 8%/6% required noninvasive/invasiveventilation. Inpatient mortality was 34 and 23% in MM and noncancer patients, respectively. Among MM patients,inpatient mortality was 41% in males, 42% in patients aged >65 years, 49% in patients with active/progressive MM athospitalization, and 59% in patients with comorbid renal disease at hospitalization, which were independentprognostic factors on adjusted multivariate analysis. This case series demonstrates the increased risk and identifiespredictors of inpatient mortality among MM patients hospitalized with COVID-19
Real-life disease monitoring in follicular lymphoma patients using liquid biopsy ultra-deep sequencing and PET/CT
In the present study, we screened 84 Follicular Lymphoma patients for somatic mutations suitable as liquid biopsy MRD biomarkers using a targeted next-generation sequencing (NGS) panel. We found trackable mutations in 95% of the lymph node samples and 80% of the liquid biopsy baseline samples. Then, we used an ultra-deep sequencing approach with 2 · 10â4 sensitivity (LiqBio-MRD) to track those mutations on 151 follow-up liquid biopsy samples from 54 treated patients. Positive LiqBio-MRD at first-line therapy correlated with a higher risk of progression both at the interim evaluation (HRINT 11.0, 95% CI 2.10â57.7, pâ=â0.005) and at the end of treatment (HREOT, HR 19.1, 95% CI 4.10â89.4, pâ<â0.001). Similar results were observed by PET/CT Deauville score, with a median PFS of 19 months vs. NR (pâ<â0.001) at the interim and 13 months vs. NR (pâ<â0.001) at EOT. LiqBio-MRD and PET/CT combined identified the patients that progressed in less than two years with 88% sensitivity and 100% specificity. Our results demonstrate that LiqBio-MRD is a robust and non-invasive approach, complementary to metabolic imaging, for identifying FL patients at high risk of failure during the treatment and should be considered in future response-adapted clinical trials.This study has been funded by Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union through the projects PI21/00314, PI19/01430, PI19/01518 and PI18/00295, PTQ2020-011372, CP19/00140, CP22/00082, Doctorado industrial CAM IND2020/TIC-17402 and CRIS cancer foundation
MM, SARS-CoV-2 infection, and inpatient mortality
There is limited information on the characteristics, pre-admission prognostic factors, and outcomes of patients with multiple myeloma (MM) hospitalized with coronavirus disease 2019 (COVID-19). This retrospective case series investigated characteristics and outcomes of 167 MM patients hospitalized with COVID-19 reported from 73 hospitals within the Spanish Myeloma Collaborative Group network in Spain between March 1 and April 30, 2020. Outcomes were compared with a randomly selected contemporary cohort of 167 age-/sex-matched non-cancer patients with COVID-19 admitted at 6 participating hospitals. Common demographic, clinical, laboratory, treatment, and outcome variables were collected; specific disease status and treatment data were collected for MM patients. Among the MM and non-cancer patients, median age was 71 years and 57% of patients were male in each series, and 75% and 77% of patients, respectively, had at least one comorbidity. COVID-19 clinical severity was moderate-severe in 77% and 89% of patients and critical in 8% and 4%, respectively. Supplemental oxygen was required by 47% and 55% of MM and non-cancer patients, respectively, and 21%/9% vs 8%/6% required non-invasive/invasive ventilation. Inpatient mortality was 34% and 23% in MM and non-cancer patients, respectively. Among MM patients, inpatient mortality was 41% in males, 42% in patients aged >65 years, 49% in patients with active/progressive MM at hospitalization, and 59% in patients with comorbid renal disease at hospitalization, which were independent prognostic factors of inpatient mortality on adjusted multivariate analysis. This case series demonstrates the increased risk and identifies predictors of inpatient mortality among MM patients hospitalized with COVID-19.This study was supported by PETHEMA FoundationN
Detection of kinase domain mutations in BCR::ABL1 leukemia by ultra-deep sequencing of genomic DNA
The screening of the BCR::ABL1 kinase domain (KD) mutation has become a routine analysis in case of warning/failure for chronic myeloid leukemia (CML) and B-cell precursor acute lymphoblastic leukemia (ALL) Philadelphia (Ph)-positive patients. In this study, we present a novel DNA-based next-generation sequencing (NGS) methodology for KD ABL1 mutation detection and monitoring with a 1.0Eâ4 sensitivity. This approach was validated with a well-stablished RNA-based nested NGS method. The correlation of both techniques for the quantification of ABL1 mutations was high (Pearson r = 0.858, p < 0.001), offering DNA-DeepNGS a sensitivity of 92% and specificity of 82%. The clinical impact was studied in a cohort of 129 patients (n = 67 for CML and n = 62 for B-ALL patients). A total of 162 samples (n = 86 CML and n = 76 B-ALL) were studied. Of them, 27 out of 86 harbored mutations (6 in warning and 21 in failure) for CML, and 13 out of 76 (2 diagnostic and 11 relapse samples) did in B-ALL patients. In addition, in four cases were detected mutation despite BCR::ABL1 < 1%. In conclusion, we were able to detect KD ABL1 mutations with a 1.0Eâ4 sensitivity by NGS using DNA as starting material even in patients with low levels of disease.Tis project was funded in part by CRIS CANCER FOUNDATION
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