Patient outcomes (DFS, PFS and OS) were examined in association with the top 10 most frequent ctDNA alterations (PIK3CA, TP53, FGFR1, ATM, CCND1, ARID1A, AKT3, MYC, ESR1 and CCND2) detected across all patients at the time of metastatic disease diagnosis (Figure 5). Here, ESR1 is linked to metastatic neoplasm.