Validation of a Molecular Diagnostic Test for Circulating Tumor DNA by Next-Gen Sequencing

Int J Mol Sci. 2023 Oct 30;24(21):15779. doi: 10.3390/ijms242115779.

Abstract

A modified version of the PGDx elioTM Plasma Resolve assay was validated as a laboratory-developed test (LDT) for clinical use in the Molecular Diagnostics Laboratory at Fox Chase Cancer Center. The test detects single nucleotide variants (SNVs) and small insertions and deletions (indels) in 33 target genes using fragmented genomic DNA extracted from plasma. The analytical performance of this assay was assessed with reference standard DNA and 29 samples from cancer patients and detected 66 SNVs and 23 indels. Using 50 ng of input DNA, the sensitivity was 95.5% to detect SNVs at 0.5% allele frequency, and the specificity was 92.3%. The sensitivity to detect indels at 1% allele frequency was 70.4%. A cutoff of 0.25% variant allele frequency (VAF) was set up for diagnostic reporting. An inter-laboratory study of concordance with an orthologous test resulted in a positive percent agreement (PPA) of 91.7%.

Keywords: assay performance assessment; cfDNA; clinical cancer genotyping; ctDNA; laboratory-developed test.

MeSH terms

  • Biomarkers, Tumor / genetics
  • Circulating Tumor DNA* / genetics
  • High-Throughput Nucleotide Sequencing / methods
  • Humans
  • INDEL Mutation
  • Molecular Diagnostic Techniques
  • Mutation
  • Neoplasms* / diagnosis
  • Neoplasms* / genetics
  • Pathology, Molecular

Substances

  • Circulating Tumor DNA
  • Biomarkers, Tumor

Grants and funding

The authors declare no financial support was received for the study and/or publication of this article.