COMBINATORIAL DNA SCREENING
The present disclosure relates to a laboratory execution system that provides for automation of laboratory processes. A centralized data management system may be dynamically updated and used to facilitate management of components of the laboratory execution system, such as an automation system and an analytics results management system that may facilitate complex analytical functions, such as synthesizing raw test data. Potential workflows include the detection of specific molecules of interest.
1 . A method for detecting circulating tumor DNA (ctDNA) in a plasma sample, comprising:
(a) obtaining a tumor sample and a matched non-tumor tissue sample from a cancer patient;
(b) performing whole exome sequencing on DNA from the tumor sample and DNA from the matched non-tumor tissue sample, thereby obtaining exome sequences from the tumor sample and exome sequences from the matched non-tumor tissue sample;
(c) obtaining a set of tumor-specific mutation sequences that are present in the exome sequences of the tumor sample but not present in the exome sequences of the matched non-tumor tissue sample;
(d) obtaining a plasma sample from the cancer patient;
(e) enriching a fraction of DNA from the plasma sample by PCR-target enrichment, wherein DNA from the plasma is contacted with a plurality of primer pairs that amplify a patient-specific signature panel, wherein each primer pair is capable of amplifying a target sequence comprising one of the tumor-specific mutation sequences or a corresponding unmutated sequence, thereby obtaining an enriched fraction of DNA;
(f) sequencing the enriched fraction of DNA, thereby obtaining a plurality of sequence reads; and
(g) detecting the presence or absence of the ctDNA, wherein the presence of one or more sequence reads in the plurality of sequence reads corresponding to one or more of the tumor-specific mutation sequences indicates the presence of ctDNA in the plasma sample.
2 . The method of claim 1 , wherein the cancer patient has or had a cancer selected from adrenal cancer, anal cancer, bile duct cancer, bladder cancer, bone cancer, a brain/CNS tumor, breast cancer, Castleman disease, cervical cancer, colon or rectum cancer, endometrial cancer, esophagus cancer, a Ewing tumor, eye cancer, gallbladder cancer, a gastrointestinal carcinoid tumor, a gastrointestinal stromal tumor (GIST), gestational trophoblastic disease, Hodgkin disease, Kaposi sarcoma, kidney cancer, laryngeal and hypopharyngeal cancer, leukemia, liver cancer, lung cancer, lymphoma, malignant mesothelioma, multiple myeloma, myelodysplastic Syndrome, nasal cavity or paranasal sinus cancer, nasopharyngeal cancer, neuroblastoma, oral cavity or oropharyngeal cancer, osteosarcoma, ovarian cancer, pancreatic cancer, penile cancer, a pituitary tumor, prostate cancer, retinoblastoma, rhabdomyosarcoma, salivary gland cancer, skin cancer, small intestine cancer, stomach cancer, testicular cancer, thymus cancer, thyroid cancer, uterine sarcoma, vaginal cancer, vulvar cancer, Waldenstrom macroglobulinemia, and Wilms tumor.
3 . The method of claim 1 , further comprising repeating (d)-(g) of the method at one or more times during a treatment.
4 . The method of claim 3 , wherein the treatment is selected from chemotherapy or radiotherapy.
5 . The method of claim 1 , further comprising repeating (d)-(g) of the method at one or more times following completion of a treatment.
6 . The method of claim 3 , wherein the treatment is selected from chemotherapy or radiotherapy.
7 . The method of claim 1 , further comprising repeating (d)-(g) of the method at one or more times while the cancer patient is in remission.
8 . The method of claim 1 , further comprising repeating (d)-(g) of the method at one or more times coinciding with or prior to surgery.
9 . The method of claim 1 , wherein the tumor-specific mutation sequences comprise one or more mutations selected from SNPs, insertions, deletions, and translocations.
10 . The method of claim 1 , wherein the patient-specific signature panel comprises greater than 50 tumor-specific mutation sequences.
11 . The method of claim 1 , wherein the patient-specific signature panel comprises at least 500 tumor-specific mutation sequences.
12 . A method for enriching circulating tumor DNA (ctDNA) in a plasma sample from a cancer patient, comprising:
(a) obtaining a tumor sample and a matched non-tumor tissue sample from a cancer patient;
(b) performing whole exome sequencing on DNA from the tumor sample and DNA from the matched non-tumor tissue sample, thereby obtaining exome sequences from the tumor sample and exome sequences from the matched non-tumor tissue sample;
(c) obtaining a set of tumor-specific mutation sequences that are present in the exome sequences of the tumor sample but not present in the exome sequences of the matched non-tumor tissue sample;
(d) obtaining a plasma sample from the cancer patient;
(e) extracting cell-free DNA fragments (cfDNA) from the plasma sample;
(f) enriching a fraction of ctDNA from the cfDNA extracted from the plasma sample by PCR-target enrichment, wherein cfDNA from the plasma is contacted with a plurality of primer pairs that amplify a patient-specific signature panel, wherein each primer pair is capable of amplifying a target sequence comprising one of the tumor-specific mutation sequences or a corresponding unmutated sequence, thereby obtaining an enriched fraction of ctDNA.
13 . The method of claim 12 , wherein the cancer patient has a cancer selected from adrenal cancer, anal cancer, bile duct cancer, bladder cancer, bone cancer, a brain/CNS tumor, breast cancer, Castleman disease, cervical cancer, colon or rectum cancer, endometrial cancer, esophagus cancer, a Ewing tumor, eye cancer, gallbladder cancer, a gastrointestinal carcinoid tumor, a gastrointestinal stromal tumor (GIST), gestational trophoblastic disease, Hodgkin disease, Kaposi sarcoma, kidney cancer, laryngeal and hypopharyngeal cancer, leukemia, liver cancer, lung cancer, lymphoma, malignant mesothelioma, multiple myeloma, myelodysplastic Syndrome, nasal cavity or paranasal sinus cancer, nasopharyngeal cancer, neuroblastoma, oral cavity or oropharyngeal cancer, osteosarcoma, ovarian cancer, pancreatic cancer, penile cancer, a pituitary tumor, prostate cancer, retinoblastoma, rhabdomyosarcoma, salivary gland cancer, skin cancer, small intestine cancer, stomach cancer, testicular cancer, thymus cancer, thyroid cancer, uterine sarcoma, vaginal cancer, vulvar cancer, Waldenstrom macroglobulinemia, and Wilms tumor.
14 . The method of claim 12 , wherein (d)-(f) of the method are performed after the cancer patient has received a treatment for cancer.
15 . The method of claim 12 , wherein (d)-(f) of the method are performed while the cancer patient is in remission.
16 . The method of claim 12 , wherein the tumor-specific mutation sequences comprise one or more mutations selected from SNPs, insertions, deletions, and translocations.
17 . The method of claim 12 , wherein the patient-specific signature panel comprises at least 50 tumor-specific mutation sequences.
18 . The method of claim 12 , wherein the patient-specific signature panel comprises at least 500 tumor-specific mutation sequences.
19 . The method of claim 12 , further comprising (g) sequencing the enriched fraction of ctDNA.
20 . The method of claim 19 , wherein (d)-(g) of the method are repeated at one or more times during a treatment.
21 . The method of claim 20 , wherein the treatment is selected from chemotherapy or radiotherapy.
22 . The method of claim 19 , wherein (d)-(g) of the method are repeated at one or more times following completion of a treatment.
23 . The method of claim 22 , wherein the treatment is selected from chemotherapy or radiotherapy.
24 . The method of claim 19 , wherein (d)-(g) of the method are repeated at one or more times while the cancer patient is in remission.
25 . The method of claim 19 , wherein (d)-(g) of the method are repeated at one or more times coinciding with or prior to surgery.
26 . A method for detecting circulating tumor DNA (ctDNA) in a plasma sample, comprising:
(a) obtaining a tumor sample and a matched non-tumor tissue sample from a cancer patient;
(b) performing whole exome sequencing on DNA from the tumor sample and DNA from the matched non-tumor tissue sample, thereby obtaining exome sequences from the tumor sample and exome sequences from the matched non-tumor tissue sample;
(c) obtaining a set of tumor-specific mutation sequences that are present in the exome sequences of the tumor sample but not present in the exome sequences of the matched non-tumor tissue sample;
subsequent to obtaining the set of tumor-specific mutation sequences:
(d) obtaining a plasma sample from the cancer patient;
(e) enriching a fraction of DNA from the plasma sample by PCR-target enrichment, wherein DNA from the plasma is contacted with a plurality of primer pairs that amplify a patient-specific signature panel, wherein each primer pair is capable of amplifying a target sequence comprising one of the tumor-specific mutation sequences or a corresponding unmutated sequence, thereby obtaining an enriched fraction of DNA;
(f) sequencing the enriched fraction of DNA, thereby obtaining a plurality of sequence reads; and
(g) detecting the presence or absence of the ctDNA, wherein the presence of one or more sequence reads in the plurality of sequence reads corresponding to one or more of the tumor-specific mutation sequences indicates the presence of ctDNA in the plasma sample;
wherein (d)-(g) are performed after the cancer patient has received a treatment for cancer or while the cancer patient is in remission.
27 . The method of claim 26 , wherein the patient-specific signature panel comprises at least 50 tumor-specific mutation sequences.
28 . The method of claim 26 , wherein the patient-specific signature panel comprises at least 500 tumor-specific mutation sequences.
29 . The method of claim 26 , wherein the cancer patient has or had a cancer selected from adrenal cancer, anal cancer, bile duct cancer, bladder cancer, bone cancer, a brain/CNS tumor, breast cancer, Castleman disease, cervical cancer, colon or rectum cancer, endometrial cancer, esophagus cancer, a Ewing tumor, eye cancer, gallbladder cancer, a gastrointestinal carcinoid tumor, a gastrointestinal stromal tumor (GIST), gestational trophoblastic disease, Hodgkin disease, Kaposi sarcoma, kidney cancer, laryngeal and hypopharyngeal cancer, leukemia, liver cancer, lung cancer, lymphoma, malignant mesothelioma, multiple myeloma, myelodysplastic Syndrome, nasal cavity or paranasal sinus cancer, nasopharyngeal cancer, neuroblastoma, oral cavity or oropharyngeal cancer, osteosarcoma, ovarian cancer, pancreatic cancer, penile cancer, a pituitary tumor, prostate cancer, retinoblastoma, rhabdomyosarcoma, salivary gland cancer, skin cancer, small intestine cancer, stomach cancer, testicular cancer, thymus cancer, thyroid cancer, uterine sarcoma, vaginal cancer, vulvar cancer, Waldenstrom macroglobulinemia, and Wilms tumor.