In addition, these three variants were also detected in the normal-paired DNA, from the peripheral blood sample obtained during the second recurrence (from whole blood, not from plasma), with allele frequency of 0.2% for KRAS (G12D) and 0.1% for GNAS (R201C) and FBXW7 (R367*) (Fig. 4d), which suggest either the existence of circulating tumor cells or highly abundant cell free DNA from the tumor. This evidence concerns the gene GNAS and neoplasm.