Ontology highlight
ABSTRACT: Purpose
Liquid biopsy offers a minimally invasive tool to diagnose and monitor the heterogeneous molecular landscape of tumors over time and therapy. Detection of TERT promoter mutations (C228T, C250T) in cfDNA has been successful for some systemic cancers but has yet to be demonstrated in gliomas, despite the high prevalence of these mutations in glioma tissue (>60% of all tumors).Experimental design
Here, we developed a novel digital droplet PCR (ddPCR) assay that incorporates features to improve sensitivity and allows for the simultaneous detection and longitudinal monitoring of two TERT promoter mutations (C228T and C250T) in cfDNA from the plasma of patients with glioma.Results
In baseline performance in tumor tissue, the assay had perfect concordance with an independently performed clinical pathology laboratory assessment of TERT promoter mutations in the same tumor samples [95% confidence interval (CI), 94%-100%]. Extending to matched plasma samples, we detected TERT mutations in both discovery and blinded multi-institution validation cohorts with an overall sensitivity of 62.5% (95% CI, 52%-73%) and a specificity of 90% (95% CI, 80%-96%) compared with the gold-standard tumor tissue-based detection of TERT mutations. Upon longitudinal monitoring in 5 patients, we report that peripheral TERT-mutant allele frequency reflects the clinical course of the disease, with levels decreasing after surgical intervention and therapy and increasing with tumor progression.Conclusions
Our results demonstrate the feasibility of detecting circulating cfDNA TERT promoter mutations in patients with glioma with clinically relevant sensitivity and specificity.
SUBMITTER: Muralidharan K
PROVIDER: S-EPMC7785705 | biostudies-literature | 2021 Jan
REPOSITORIES: biostudies-literature
Muralidharan Koushik K Yekula Anudeep A Small Julia L JL Rosh Zachary S ZS Kang Keiko M KM Wang Lan L Lau Spencer S Zhang Hui H Lee Hakho H Bettegowda Chetan C Chicoine Michael R MR Kalkanis Steven N SN Shankar Ganesh M GM Nahed Brian V BV Curry William T WT Jones Pamela S PS Cahill Daniel P DP Balaj Leonora L Carter Bob S BS
Clinical cancer research : an official journal of the American Association for Cancer Research 20201013 1
<h4>Purpose</h4>Liquid biopsy offers a minimally invasive tool to diagnose and monitor the heterogeneous molecular landscape of tumors over time and therapy. Detection of <i>TERT</i> promoter mutations (<i>C228T</i>, <i>C250T</i>) in cfDNA has been successful for some systemic cancers but has yet to be demonstrated in gliomas, despite the high prevalence of these mutations in glioma tissue (>60% of all tumors).<h4>Experimental design</h4>Here, we developed a novel digital droplet PCR (ddPCR) ass ...[more]