Enrichment of mutated cell free nucleic acids for cancer detection

1. A method for enriching a plurality of target nucleic acids in a sample, the method comprising:

providing an endonuclease system;

wherein each of the plurality of target nucleic acids comprises:

a first variant comprising a wild-type allele sequence selected from the group consisting of: AKT1, BRAF, EGFR, KRAS, MAP2K1, NRAS, PI3KCA and PTEN; and

a second variant,

wherein the endonuclease system comprises a plurality of clustered regularly interspaced short palindromic repeat (CRISPR) RNAs (crRNAs), or derivatives thereof, each crRNA comprising a targeting sequence, and a plurality of CRISPR-associated (Cas) proteins, or variants thereof, each Cas protein capable of binding to a protospacer adjacent motif (PAM) site on a target nucleic acid,

wherein the first variant of each target nucleic acid comprises a PAM site adjacent to a region complementary to a crRNA targeting sequence, and wherein the second variant does not comprise the PAM site or does not comprise the region complementary to the crRNA targeting sequence adjacent to the PAM site, and

contacting the sample with the endonuclease system, thereby depleting the first variant and enriching the second variant of each of the plurality of target nucleic acids in the sample.

2. The method of claim 1 , wherein the second variant of each of the plurality of target nucleic acids comprises a mutant allele sequence.

3. The method of claim 2 , wherein the mutant allele sequence comprises a mutant allele sequence selected from the group consisting of: AKT1, BRAF, EGFR, KRAS, MAP2K1, NRAS, PI3KCA and PTEN.

4. The method of claim 2 , wherein the mutant allele sequence is selected from the group consisting of: AKT1-E17K, BRAF-V600E, BRAF-L597V, BRAF-G469A, BRAF-G466V, EGFR-E709 T710delins, EGFR-G719S, EGFR-G719C, EGFR-G719A, EGFR-Exon19del, EGFR-T790M, EGFR-L858R, EGFR-L861Q, KRAS-Q61H, KRAS-Q61L, KRAS-Q61R, KRAS-Q61K, KRAS-G13A, KRAS-G13D, KRAS-G13C, KRAS-G13R, KRAS-G13D, KRAS-G13C, KRAS-G13R, KRAS-G13S, KRAS-G12V, KRAS-G12A, KRAS-G12D, KRAS-G12D, KRAS-G12C, KRAS-G12R, KRAS-G12S, MAP2K1-Q56P, NRAS-Q61H, NRAS-Q61L, NRAS-Q61R, NRAS-Q61K, NRAS-G12A, NRAS-G12D, NRAS-G12C, NRAS-G12R, NRAS-G12S, PI3KCA-E542K, PI3KCA-E545Q, PI3KCA-E545K, PI3KCA-H1047R, PI3KCA-H1047L, and PTEN-R233*.

5. The method of claim 2 , wherein the mutant allele sequence comprises a mutant allele sequence according to FIG. 7 .

6. The method of claim 1 , wherein the sample comprises a blood, serum, plasma, urine, or cerebrospinal fluid sample.

7. The method of claim 1 , wherein the plurality of target nucleic acids comprises cell-free DNA (cfDNA) or cell-free RNA (cfRNA).

8. The method of claim 1 , wherein the plurality of Cas proteins comprises Cas9, or a variant thereof, a Cas9 ortholog, or a variant thereof, or Cpfl, or a variant thereof, and wherein the Cas9, or variant thereof, is derived from Streptococcus pyogenes , or wherein the Cpfl, or variant thereof, is derived from Francisell novicida U112.

9. The method of claim 1 , wherein the first variant of each target nucleic acid comprises a PAM site adjacent to a region complementary to a crRNA targeting sequence, and the second variant does not comprise the PAM site.

10. The method of claim 1 , wherein the first variant of each target nucleic acid comprises a PAM site adjacent to a region complementary to a crRNA targeting sequence, and the second variant does not comprise the region complementary to the crRNA targeting sequence adjacent to the PAM site.

11. The method of claim 1 , wherein the first variant of one or more of the plurality of target nucleic acid sequences comprises a PAM site comprising the sequence 5′-TTN-3′, wherein N comprises A, G, C, or T, and wherein the second variant does not comprise the PAM site.

12. The method of claim 1 , wherein the first variant of one or more of the plurality of target nucleic acid sequences comprises a PAM site, and wherein the second variant comprises a deletion of the PAM site.

13. The method of claim 1 , wherein the first variant of one or more of the plurality of target nucleic acid sequences comprises a region complementary to a crRNA targeting sequence adjacent to a PAM site and the second variant comprises an insertion of 1 or more, 2 or more, 3 or more, 4 or more, 5 or more, 6 or more, 7 or more, 8 or more, 9 or more, 10 or more, 12 or more, 14 or more, 16 or more, 18 or more, or 20 or more base pairs (bps) within 50 bps, 40 bps, 30 bps, 20 bps, or 10 bps upstream of the PAM site.

14. The method of claim 1 , wherein the first variant of one or more of the plurality of target nucleic acid sequences comprises a region complementary to a crRNA targeting sequence adjacent to a PAM site, and the second variant does not comprise the region complementary to the crRNA targeting sequence adjacent to the PAM site.

15. The method of claim 14 , wherein in the second variant the region adjacent to the PAM site comprises a point mutation.

16. The method of claim 14 , wherein in the second variant the region adjacent to the PAM site comprises the junction of a fusion gene.

17. The method of claim 1 , wherein the endonuclease system further comprises a crRNA and Cas protein targeting an abundant wild-type target nucleic acid in the sample.

18. The method of claim 17 , wherein the abundant wild-type target nucleic acid is selected from the group consisting of a ribosomal RNA and a globin RNA.

19. A method for enriching a plurality of target nucleic acids in a sample, the method comprising:

providing an endonuclease system;

wherein each of the plurality of target nucleic acids comprises a first variant and a second variant,

wherein the endonuclease system comprises a plurality of clustered regularly interspaced short palindromic repeat (CRISPR) RNAs (crRNAs), or derivatives thereof, each crRNA comprising a targeting sequence, and a plurality of CRISPR-associated (Cas) proteins, or variants thereof, each Cas protein capable of binding to a protospacer adjacent motif (PAM) site on a target nucleic acid,

wherein the first variant of each target nucleic acid comprises a PAM site adjacent to a region complementary to a crRNA targeting sequence adjacent to the PAM site, and wherein the second variant does not comprise the region complementary to the crRNA targeting sequence adjacent to the PAM site, and wherein in the second variant the region adjacent to the PAM site comprises the junction of a fusion gene; and

contacting the sample with the endonuclease system, thereby depleting the first variant and enriching the second variant of each of the plurality of target nucleic acids in the sample.

20. The method of claim 19 , wherein in the second variant the region adjacent to the PAM site comprises a point mutation.

21. A method for enriching a plurality of target nucleic acids in a sample, the method comprising:

providing an endonuclease system;

wherein each of the plurality of target nucleic acids comprises a first variant and a second variant,

wherein the endonuclease system comprises a plurality of clustered regularly interspaced short palindromic repeat (CRISPR) RNAs (crRNAs), or derivatives thereof, each crRNA comprising a targeting sequence, and a plurality of CRISPR-associated (Cas) proteins, or variants thereof, each Cas protein capable of binding to a protospacer adjacent motif (PAM) site on a target nucleic acid,

wherein the endonuclease system further comprises a crRNA and Cas protein targeting an abundant wild-type target nucleic acid in the sample,

wherein the abundant wild-type target nucleic acid is selected from the group consisting of: a ribosomal RNA and a globin RNA;

wherein the first variant of each target nucleic acid comprises a PAM site adjacent to a region complementary to a crRNA targeting sequence, and wherein the second variant does not comprise the PAM site or does not comprise the region complementary to the crRNA targeting sequence adjacent to the PAM site, and

contacting the sample with the endonuclease system, thereby depleting the first variant and enriching the second variant of each of the plurality of target nucleic acids in the sample.