Notably, exo-DNA at progression showed some variants in NB driver genes as CASZ1, PBX2, DMBT1, and PTPN11 [6], but even more importantly, exo-DNA at onset already displayed pathogenic mutations on the NB driver genes PTPN11 and FGFR1. The PTPN11 mutation was also present on tumor DNA at onset (Supplementary Table S1). The gene discussed is PTPN11; the disease is neuroblastoma.