Waterfall Chart
Chart overview
In oncology clinical trials, a waterfall chart displays each patient as a vertical bar representing their best percentage change in tumor burden from baseline, sorted from largest reduction (left) to largest progression (right), creating a characteristic waterfall shape.
Key points
- Horizontal reference lines at -30% (partial response threshold per RECIST 1.
- 1) and +20% (progressive disease threshold) divide patients into response categories.
- Bars are colored by response category - complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) - enabling rapid visual assessment of drug activity across the cohort.
Example Visualization
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"Create an oncology waterfall chart from my clinical trial data with patient IDs and best percent change from baseline. Sort patients from largest decrease to largest increase. Color bars by RECIST response: complete response dark green, partial response green, stable disease grey, progressive disease red. Add horizontal dashed reference lines at -30% and +20%. Label the y-axis as 'Best Change from Baseline (%)'. Include a response category legend and annotate the number and percentage of responders. Format for New England Journal of Medicine standards at 300 DPI."
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Python Code Example
Console Output
Figure saved: plotivy-waterfall-chart.png
Common Use Cases
- 1Phase I/II oncology clinical trial efficacy reporting: best overall tumor response per patient
- 2Immunotherapy response monitoring: percent change in total tumor burden over treatment course
- 3Hematology: displaying M-protein reduction in multiple myeloma patients on novel agents
- 4Combination therapy studies: comparing waterfall distributions between treatment arms
Pro Tips
Sort bars from most negative to most positive change for the characteristic waterfall shape
Use RECIST 1.1 thresholds (-30% PR, +20% PD) unless your protocol specifies alternate criteria
Annotate confirmed vs. unconfirmed responses differently if confirmation scan is required by protocol
Include a table below the waterfall listing tumor type, treatment cycles, and censoring status per patient
Scientific Chart Selection Cheat Sheet
Not sure whether to use a Violin Plot, Box Plot, or Ridge Plot? Download our single-page reference mapping the most-used scientific chart types, exactly when to use them, and the core Matplotlib/Seaborn functions.