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Waterfall Plot (Tumor Response)

Per-patient best percentage change from baseline in target-lesion sum, sorted descending, with RECIST 1.1 response (−30%) and progression (+20%) thresholds shown as horizontal reference lines. Provides an individual-level view of anti-tumor activity that complements aggregate response rates.

Waterfall Plot (Tumor Response): Per-patient best percentage change from baseline in target-lesion sum, sorted descending, with RECIST 1.1 response (−30%) and progression (+20%) thresholds shown as horizontal reference lines. Provides an individual-level view of anti-tumor activity that complements aggregate response rates.
Download SVG Open code and full worked example
When to use it

Oncology efficacy analyses where target-lesion measurements are available per patient (clinical trial or registry-linked RWD). Use to display the full distribution of anti-tumor activity, reveal the mix of responders and progressors, and identify patients near RECIST thresholds. Requires at least one post-baseline measurement per patient.

How to read it

Each bar is one patient; bar height = best % change from baseline (negative = shrinkage, positive = growth). The −30% line (vermilion dashed) is the RECIST 1.1 partial-response threshold; bars below it are responders (PR or CR). The +20% line (teal dashed) is the progressive-disease threshold. Bars between the two lines are stable disease. Color-coded bars make the three zones immediately visible.

Worked example

25 oncology patients with target-lesion measurements at baseline and ≥1 post-baseline scan. Best percentage changes range from −82% (deepest responder) to +58% (strongest progressor). 10 patients achieve PR (≤−30%), 8 have SD (−30% to +20%), 7 have PD (>+20%). Bars are sorted descending (most positive left, most negative right).

Synthetic best_pct_change values (sorted descending): [−82, −71, −65, −58, −52, −45, −40, −38, −33, −31, −18, −10, −5, 2, 6, 11, 14, 18, 22, 29, 35, 41, 46, 51, 58].

Result: Response rate = 10/25 = 40% (PR; no CR in this cohort). Stable disease = 8/25 = 32%. Progressive disease = 7/25 = 28%. Median best change = −5% (13th bar, in the SD zone). These counts and the bar heights are directly visible in the rendered SVG (sorted data: 10 bars at or below −30%, 8 bars in −30% to +20%, 7 bars above +20%).

Produced by
Real-world progression-free survival (rwPFS)Therapeutic-area challenges — Oncology

Reference: Gatto NM, Wang SV, Murk W, et al. Visualizations throughout pharmacoepidemiology study planning, implementation, and reporting. Pharmacoepidemiol Drug Saf. 2022;31(11):1140-1152.