The iceberg plot, improving the visualisation of therapy response in oncology in the era of sequence-directed therapy

Modern clinical cancer research increasingly relies on the visual communication of complex response and treatment sequencing data. Graphical representations used in oncology currently fail to provide adequate information on any prior treatment(s) responses, focussing on current treatment effects in isolation. We have developed a new graphical illustration, the 'iceberg plot,' to allow improved comparison of prior treatment response with current therapy. To demonstrate the potential clinical utility of this new graphical representation, we have performed an independent reanalysis of a clinical study trialling sequence-directed therapy. In this example, prior therapy responses are contrasted with current treatment response, with further validation using the 'Von Hoff' criteria to assess for exceptional response. This example demonstrates the versatility and clinical utility of the 'iceberg plot,' showing what was previously hidden and provides improved visualisation of prior and current treatment responses together.