Integration of whole-exome and anchored PCR-based next generation sequencing significantly increases detection of actionable alterations in precision oncology.

TitleIntegration of whole-exome and anchored PCR-based next generation sequencing significantly increases detection of actionable alterations in precision oncology.
Publication TypeJournal Article
Year of Publication2021
AuthorsBeg S, Bareja R, Ohara K, Eng KWha, Wilkes DC, Pisapia DJ, Zoughbi WAl, Kudman S, Zhang W, Rao R, Manohar J, Kane T, Sigouros M, Xiang JZhaoying, Khani F, Robinson BD, Faltas BM, Sternberg CN, Sboner A, Beltran H, Elemento O, Mosquera JMiguel
JournalTransl Oncol
Volume14
Issue1
Pagination100944
Date Published2021 Jan
ISSN1936-5233
Abstract

BACKGROUND: Frequency of clinically relevant mutations in solid tumors by targeted and whole-exome sequencing is ∼30%. Transcriptome analysis complements detection of actionable gene fusions in advanced cancer patients. Goal of this study was to determine the added value of anchored multiplex PCR (AMP)-based next-generation sequencing (NGS) assay to identify further potential drug targets, when coupled with whole-exome sequencing (WES).

METHODS: Selected series of fifty-six samples from 55 patients enrolled in our precision medicine study were interrogated by WES and AMP-based NGS. RNA-seq was performed in 19 cases. Clinically relevant and actionable alterations detected by three methods were integrated and analyzed.

RESULTS: AMP-based NGS detected 48 fusions in 31 samples (55.4%); 31.25% (15/48) were classified as targetable based on published literature. WES revealed 29 samples (51.8%) harbored targetable alterations. TMB-high and MSI-high status were observed in 12.7% and 1.8% of cases. RNA-seq from 19 samples identified 8 targetable fusions (42.1%), also captured by AMP-based NGS. When number of actionable fusions detected by AMP-based NGS were added to WES targetable alterations, 66.1% of samples had potential drug targets. When both WES and RNA-seq were analyzed, 57.8% of samples had targetable alterations.

CONCLUSIONS: This study highlights importance of an integrative genomic approach for precision oncology, including use of different NGS platforms with complementary features. Integrating RNA data (whole transcriptome or AMP-based NGS) significantly enhances detection of potential targets in cancer patients. In absence of fresh frozen tissue, AMP-based NGS is a robust method to detect actionable fusions using low-input RNA from archival tissue.

DOI10.1016/j.tranon.2020.100944
Alternate JournalTransl Oncol
PubMed ID33190043
PubMed Central IDPMC7674614
Related Faculty: 
Andrea Sboner, Ph.D. Brian Robinson, M.D. David Pisapia, M.D. Francesca Khani, M.D. Juan Miguel Mosquera, M.D.

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