TUMOR NUCLEIC ACID IDENTIFICATION METHODS
Provided herein are methods of detecting tumor nucleic acids in a biological sample of a subject.
1 .- 43 . (canceled)
44 . A method of detecting a tumor nucleic acid in a cell-free biological sample from a subject, the method comprising:
(a) sequencing nucleic acids derived from a tumor of said subject to obtain a tumor specific sequence variant;
(b) sequencing a nucleic acid derived from said cell-free biological sample, wherein said sequencing is at a depth of no greater than 18 reads per nucleic acid molecule;
(c) processing said sequence of said cell-free biological sample to identify said tumor specific sequence variant; and
(d) identifying said nucleic acid as having at least one said tumor specific sequence variant.
45 . The method of claim 44 , wherein said sequencing of (b) is at a depth of no greater than 5 reads per nucleic acid molecule.
46 . The method of claim 44 , further comprising calling said subject as minimum residual disease (MRD) positive when said nucleic acid derived from said cell-free biological sample has said at least one said tumor specific sequence variant.
47 . The method of claim 44 , wherein step (b) further comprises (i) circularizing said nucleic acid derived from said cell-free biological sample to create a circularized nucleic acid; (ii) amplifying said circularized nucleic acid to generate a concatemer comprising at least two copies of a sequence of said circularized nucleic acid, wherein sequencing said nucleic acid derived from said cell-free biological sample comprises sequencing said concatemer or a derivative thereof to obtain a sequence of said concatemer.
48 . The method of claim 44 , wherein the tumor specific sequence variant is identified by comparing a sequence from said nucleic acids derived from the tumor to a sequence from said nucleic acid derived from said cell-free biological sample.
49 . The method of claim 44 , wherein obtaining said tumor specific sequence variant comprises sequencing nucleic acids derived from a healthy tissue of said subject.
50 . The method of claim 49 , wherein said healthy tissue has low or no tumor content.
51 . The method of claim 44 , wherein said nucleic acids derived from said tumor are subjected to selection prior to sequencing in step (a).
52 . The method of claim 51 , wherein said selection comprises negative selection to remove non-target sequences from said nucleic acids.
53 . The method of claim 51 , wherein said selection comprises positive selection to select target sequences from said nucleic acids.
54 . The method of claim 44 , further comprising, prior to (b) subjecting said nucleic acid derived from said cell-free biological sample to selection.
55 . The method of claim 54 , wherein said selection comprises negative selection to remove non-target sequences from said nucleic acids.
56 . The method of claim 55 , wherein negative selection comprises annealing one or more blocking oligonucleotides to unwanted sequences in said nucleic acids derived from said tumor or said nucleic acids derived from said healthy tissue and circularizing remaining single stranded nucleic acids.
57 . The method of claim 56 , wherein said blocking oligonucleotides have modified 5′ ends, modified 3′ ends, or modified 5′ and 3′ ends.
58 . The method of claim 54 , wherein said selection comprises positive selection to select target sequences from said nucleic acids.
59 . The method of claim 58 , wherein said positive selection comprises amplifying said nucleic acids derived from said tumor with a plurality of random primers and a plurality of target specific primers.
60 . The method of claim 44 , wherein said cell-free biological sample is a bodily fluid.
61 . The method of claim 60 , wherein said bodily fluid comprises urine, saliva, blood, serum, or plasma.
62 . The method of claim 44 , wherein said tumor is a colorectal cancer, a pancreatic cancer, an ovarian cancer, a breast cancer, a prostate cancer, a bladder cancer, a lung cancer, a skin cancer, or a blood cancer.
63 . A method of detecting a tumor nucleic acid in a cell-free biological sample from a subject, the method comprising:
(a) sequencing nucleic acids derived from a tumor of said subject to obtain a tumor specific sequence variant;
(b) sequencing a nucleic acid derived from said cell-free biological sample, wherein said sequencing is at a depth of no greater than 18 reads per nucleic acid molecule, wherein said sequencing is whole genome sequencing;
(c) processing said sequence of said cell-free biological sample to identify said tumor specific sequence variant; and
(d) identifying said nucleic acid as having at least one said tumor specific sequence variant.