Noninvasive identification and monitoring of cancer mutations by targeted deep sequencing of plasma DNA

T Forshew, M Murtaza, C Parkinson, D Gale… - Science translational …, 2012 - science.org
T Forshew, M Murtaza, C Parkinson, D Gale, DWY Tsui, F Kaper, SJ Dawson, AM Piskorz…
Science translational medicine, 2012science.org
Plasma of cancer patients contains cell-free tumor DNA that carries information on tumor
mutations and tumor burden. Individual mutations have been probed using allele-specific
assays, but sequencing of entire genes to detect cancer mutations in circulating DNA has
not been demonstrated. We developed a method for tagged-amplicon deep sequencing
(TAm-Seq) and screened 5995 genomic bases for low-frequency mutations. Using this
method, we identified cancer mutations present in circulating DNA at allele frequencies as …
Plasma of cancer patients contains cell-free tumor DNA that carries information on tumor mutations and tumor burden. Individual mutations have been probed using allele-specific assays, but sequencing of entire genes to detect cancer mutations in circulating DNA has not been demonstrated. We developed a method for tagged-amplicon deep sequencing (TAm-Seq) and screened 5995 genomic bases for low-frequency mutations. Using this method, we identified cancer mutations present in circulating DNA at allele frequencies as low as 2%, with sensitivity and specificity of >97%. We identified mutations throughout the tumor suppressor gene TP53 in circulating DNA from 46 plasma samples of advanced ovarian cancer patients. We demonstrated use of TAm-Seq to noninvasively identify the origin of metastatic relapse in a patient with multiple primary tumors. In another case, we identified in plasma an EGFR mutation not found in an initial ovarian biopsy. We further used TAm-Seq to monitor tumor dynamics, and tracked 10 concomitant mutations in plasma of a metastatic breast cancer patient over 16 months. This low-cost, high-throughput method could facilitate analysis of circulating DNA as a noninvasive “liquid biopsy” for personalized cancer genomics.
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